Preamble

The House met at half-past Nine o'clock

PRAYERS

[MADAM SPEAKER in the Chair]

Mr. Gerald Howarth: On a point of order, Madam Speaker. I am sure that you, like all of us, will have seen on television the terrible humanitarian tragedy that is currently occurring in Mozambique. Perhaps you have seen the amazing pictures of the bravery and courage of the South African helicopter pilots, who have rescued an enormous number of people with only three helicopters. On the radio this morning, the Secretary of State for International Development suggested that there was a dispute between two Departments about the deployment of United Kingdom helicopters to that part of the world. People will have been appalled to hear that the dispatch of helicopters has been delayed as a result of such a dispute.
Given the gravity of the humanitarian crisis, have you, Madam Speaker, had any intimation from the Prime Minister to the effect that he wishes to make a statement in the House about the United Kingdom Government's response, and to explain the failure to act more swiftly?

Madam Speaker: At this juncture, I have not been informed that the Prime Minister or any Minister wants to make a statement on that matter.

Mr. Eric Forth: Further to that point of order, Madam Speaker. Can you help the House by telling us the latest point at which a Minister—in this case, the Secretary of State for Defence or the Secretary of State for International Development—can approach you to ask to make a statement? It would help the House if we knew the deadline for Ministers to approach you.

Madam Speaker: Ministers are free to make statements in the House at prescribed times. However, on a Friday, I am usually informed at around 10 o'clock whether a statement is to be made, and it is usually made at 11 o'clock.

Orders of the Day — BILL PRESENTED

COUNTRYSIDE AND RIGHTS OF WAY

Mr. Secretary Prescott presented a Bill to make new provision for public access to the countryside; to amend the law relating to public rights of way; to enable traffic regulation orders to be made for the purpose of conserving an area's natural beauty; to make provision with respect to the driving of mechanically propelled vehicles elsewhere than on roads; to amend the law relating to nature conservation and the protection of wildlife; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Monday next, and to be printed [Bill 78].

Orders of the Day — Health Service Commissioners (Amendment) Bill

Order for Second Reading read.

Sir Geoffrey Johnson Smith: I beg to move, That the Bill be now read a Second time.
The Bill is designed to amend the provisions of the Health Service Commissioners Act 1993 that apply to the ombudsman's powers to investigate complaints against doctors and other health service providers such as pharmacists, dentists and ophthalmic surgeons. The Bill is therefore not confined to one section of the medical profession.
I am grateful for the cross-party support that the Bill has attracted. I should like to thank the sponsors in particular; they also span the political divide. It is worth mentioning some of the sponsors by name because they have persistently shown a great interest in health matters. Some of them not only take an interest in health in the House but are registered medical practitioners. They include: my hon. Friend the Member for Southend, West (Mr. Amess), who is a member of the Select Committee on Health, the hon. Member for Isle of Wight (Dr. Brand), who is the Liberal Democrat spokesman on health, and also serves on the Health Committee, the hon. Member for Wakefield (Mr. Hinchliffe), who chairs the Select Committee and the hon. Member for Bradford, West (Mr. Singh), who is a former hospital manager. The sponsors include two doctors. I am grateful to them for sparing their time.
The purpose of the Bill is to close a loophole in the Health Service Commissioners Act 1993, which allows general practitioners and others involved in health matters to retire to avoid investigation by the health service ombudsman. For example, GPs who are worried about being investigated by the ombudsman can simply retire from the national health service to avoid answering for their actions. That is all the more worrying because GPs who officially retire from the national health service can avoid investigation and continue to practise as locums or in private practice even though a complaint which calls into question their professional conduct and ability remains unresolved.
If the Bill makes the statute book, it will bring GPs and other health professionals into line with hospital doctors. In his annual report for 1998–99, the health service


commissioner, Mr. Michael Buckley, drew attention to the need to tackle the matter that the Bill covers. I am especially grateful to the Consumers Association for bringing the ombudsman's recommendation to my attention and for its help in preparing the Bill.
Although the Bill will affect only a few individuals each year, it will tackle a basic injustice. We have recently witnessed action by the Home Office to consider sanctions against retired police officers following the Macpherson inquiry in the Stephen Lawrence case. The Bill will introduce similar provisions to protect patients.
It is important that patients are reassured that the laws governing health services professionals are primarily designed to protect them. As well as protecting patients, the Bill would support thousands of honest and reputable doctors who tirelessly serve our communities, and would ensure, too, that the minority of doctors who should not be practising do not tarnish the reputation of exemplary doctors. It is in no way a witch hunt.
The Consumers Association has campaigned for several years for a robust system of redress in health care. I was made aware of it about a year ago when I read a report in Which? magazine—I am a subscriber—of the case of Mr. Peter Smith, whose wife had died of leukaemia, a condition that her doctor had overlooked. Mr. Smith took his complaint to the health service ombudsman, who agreed to investigate. Unfortunately for Mr. Smith, the general practitioner in question retired and the investigation was abandoned. He will never know if his complaint would have been upheld. Neither will Yvonne Fisher.
In February 1998, Mrs. Fisher called a doctor after finding her 83-year-old mother, Mrs. Valles, ill at home. The practice said that none was available. Later that afternoon, her mother's condition deteriorated and she collapsed. Mrs. Fisher left her with neighbours, drove to the practice and asked that a doctor attend to her mother urgently. Finally, a doctor visited and examined Mrs. Valles. He said that she had suffered a slight stroke and was unconcerned by Mrs. Fisher's pleadings that her mother had not eaten or drunk anything, could not walk unaided and was very weak. The doctor merely commented that that was usual with strokes.
The doctor then told Mrs. Fisher that her mother ought to be moved to a nursing home as she would never be able to look after herself again. In the meantime, he insisted that Mrs. Valles should not be on her own and that she was fit enough to embark on the two-hour journey to her daughter's home. Mrs. Fisher reluctantly put her mother in her car and drove home. On arrival, Mrs. Valles collapsed. An ambulance was called, which took her mother to a local hospital. She died shortly after arrival.
Mrs. Fisher was so incensed at the treatment that she and her mother had received that she decided to complain. She took the complaint to the West Surrey health authority, which refused to hold an independent review. That led Mrs. Fisher to contact the health service ombudsman for England, who agreed that there was a case and started an investigation. I emphasise that the complaint went to the ombudsman for England, because his remit does not run to Scotland. If the Bill meets with the House's approval, we shall have to consider what action can be taken in respect of the Scottish Parliament.
Mrs. Fisher was relieved to discover that the ombudsman was to investigate her case, only to have her hopes of justice dashed when she was informed that the doctor had decided to retire and that the case therefore had to be dropped. She decided to go public because she cannot believe that doctors can avoid investigation in that way. She hopes that the Bill will be made law so that in future people will be able to see that an investigation has been properly conducted and completed.
The Bill is supported by many notable organisations, including the British Medical Association and the Royal College of General Practitioners. Mr. Michael Buckley, the ombudsman, fully supports it and has called on the Government to take up the issue. Although this amendment to the 1993 Act would benefit only a few individuals, their plight must not be ignored. They deserve justice in the same way as any other person who put his faith in a system only for that system to fail him.
I hope that hon. Members on both sides of the House agree that the Bill represents an important first step to safeguarding patients' interests. I want it to succeed, which is why I propose only a modest change in the ombudsman's powers. No doubt the Government will wish to consider other changes in his powers and those of the General Medical Council that would improve redress in health. One could be the extension of the ombudsman's remit to the private sector, and there are others, one of which was pointed out by the Consumers Association. It published the results of its investigation into the GMC's procedures for dealing with complaints, which uncovered a system that any objective person would have to conclude could be improved. The Consumers Association has also called for the proportion of lay to medical members on the GMC to be increased to reduce the existing imbalance in some of the procedures and to drive forward reform.
The Bill represents a first step—other reforms will take time and I urge the Government to introduce legislation at the earliest opportunity—but it would sit neatly in a range of reforms that they may introduce to reflect the needs of patients and the medical profession. It is important to take this step, which will not prejudice any others that the Government may consider to strengthen the confidence that people rightly should have in an investigative complaints procedure.
Although I have concentrated my remarks on doctors, the Bill would achieve improvements in respect of other practitioners. However, the doctor-patient relationship is the backbone of the health care system. Recently, the Shipman case has shown how weaknesses in the system of redress serve only to discredit or undermine the confidence and trust between doctor and patient. I hope that the House agrees that that must be resolved.

Angela Smith: I am pleased to speak in the debate and to be a sponsor of the Bill. It is traditional to congratulate a Member on drawing a number high up in the ballot, but I confess that I have never understood that parliamentary convention. Drawing a high number is a matter of luck, but a Member deserves great credit for his choice of Bill and we should congratulate the right hon. Member for Wealden (Sir G. Johnson-Smith) on introducing a measure that would benefit a number of people. This Bill is about empowering consumers and patients and giving them confidence.
If Members from all parties outlined their reasons for standing for election, they would all say that justice, fairness and giving confidence were first among them. Those three tenets are our reasons for becoming Members of Parliament. Today's debate is about accountability, and it continues our discussion on restoring or maintaining faith in public servants—a category into which we ourselves fall—in respect of a number of issues. We should consider the Bill—which is moderate and sensible—in that context.
My view is that the system contains a number of deficiencies in relation to complaints and accountability. Although the Bill cannot possibly address them all, limiting what it sets out to achieve will make it far more successful. It targets an important specific area: ensuring that a general practitioner's retirement from the national health service does not prevent the health service ombudsman from carrying out a full investigation of a complaint. Patients visiting a doctor or a dentist must have faith that they will receive the best possible treatment. If they receive the wrong treatment or are treated unacceptably—or merely think that they have been treated unacceptably—they must know that they have recourse to a fair and just complaints system. No one in any profession should be able to duck their responsibilities by retiring or transferring to the private sector.
That debate takes place in a number of public services—the police being a prime example. Today, we can take an important step forward in patient protection and patient confidence. We should be clear that the Bill is not a panacea, but it would address one specific point.
It is unfortunate that, in the past few months, we have been made aware of some horror stories involving doctors and dentists. It was interesting to note that an opinion poll published yesterday found that that had not dented public confidence in doctors and dentists—in fact, it is still as high as it has ever been. When hon. Members talk to individuals—as we do in our surgeries and in conversations in our constituencies—we find great dissatisfaction among those who think that their complaints are not being taken seriously. It is a matter not necessarily of confidence in an individual practitioner, but of being taken seriously.
Some of the issues that have come to light in the press have been as a result of dissatisfaction at the failure of internal investigations. I say with some regret that I do not believe that the relevant regulatory medical authorities have come out of recent events with much credit.
I am sure that other hon. Members have had cause to take up complaints made against doctors by constituents. They will be as dissatisfied as I am with the delays in, for example, the procedures of the General Medical Council in investigating complaints and in responding to correspondence from Members.
One of the first cases that was brought to my attention as an MP was from my constituent Mr. Burgess. He had a complaint against his mother-in-law's GP after she had died. Like many people, he contacted me not as the first port of call but in desperation and frustration at the pace at which his complaint was being dealt with. Even after he referred the case to me, promised deadlines were missed, and I have had to write several times to ascertain what is happening. When a deadline is missed, I write again and am told that it has been extended. Where the GP has not responded to inquiries from the GMC, the case

has not been followed up until I have written to ask about it. There seems to be no sense of urgency about the investigation of the complaint, and scant acknowledgement that my constituent has complained out of genuine and heartfelt concern. A lesser man would have given up. I am still waiting for a response to an inquiry that I made on behalf of another constituent last November.
That does not give me much confidence in the system. What makes matters worse is that, in extreme cases, when a doctor or dentist retires or leaves the NHS for the private sector—sometimes in extremely dubious circumstances, as the right hon. Member for Wealden said—there is no way of following through a complaint unless criminal proceedings can be instigated.
It remains open to unscrupulous doctors and dentists who are facing an investigation and are worried about its outcome merely to retire. They can then carry on practising with no founded complaint against them.
The health service ombudsman has said that this issue should be addressed. The right hon. Gentleman rightly said that only a few people will be affected by the Bill, but the principle is important. There may only be a few isolated cases, but that does not lessen the pain and concern of the people involved. There is the potential for a more general, larger, national problem, and it is through the good will of doctors and dentists that we have not had greater difficulties. Our role as parliamentarians and legislators is to spot such loopholes and to attempt to close them.
It is important constantly to review the work and effectiveness of the public sector ombudsmen, and consider taking action, especially when they draw issues of concern to our attention. I await with interest the outcome of the review of the public sector ombudsmen that is currently with Cabinet Ministers, in the hope that we can use that to strengthen their role and act to increase public confidence. The Bill is about public confidence and protection.
I pay credit to the work of the Consumers Association in supporting the Bill and drawing such matters to our attention. There is also considerable local impetus, which is always important when we are dealing with such issues. I have received representations from my local Basildon and Thurrock community health council. It is an effective local body, and it wants to know that its concerns are being taken seriously. I have worked with the council on a number of occasions, and with Mark Ham and his team in Basildon, who want to be assured that complaints and concerns will be followed through to the very end, and that no doctor or dentist will be able to evade his or her responsibilities during investigations.
Like many others, the local community health council has had cases in which doctors under investigation have retired, so that the investigation has come to an end. That is of great concern to the council, and it has asked me to raise the issue in the House today, because this problem affects the support that it feels able to give patients who seek its advice.
The fact that a loophole exists affects patients' confidence in the system, and may result in their not proceeding with complaints because they do not think that it is worth while if a doctor can retire or move out of the NHS to avoid the complaint being considered. The system is a deterrent to complaints, and we shall never know how


many complaints have not been made for fear that they will not be taken seriously and that the doctor will not be fully investigated.
The vast majority of doctors deserve our confidence, but unless we are prepared to deal with the issues that severely test our faith in the system, we do a disservice to all doctors. Unless we tackle the real fears and concerns, we cannot expect the public to trust us, or the medical profession as a whole. When that situation develops, it undermines the work of many good doctors.
This is just one aspect of the reform of the ombudsmen's powers. It is a small reform, but it is important if we are to retain public confidence. I believe that we should considerably increase the ombudsmen's powers in this and in other areas. We cannot address that issue today, but this Bill is a welcome and necessary start.
I hope that the Minister will accept that the flaws in the system need to be dealt with as soon as possible. It is not only confidence in the medical profession that is at stake—as I have mentioned several times—but confidence in our own profession. If such problems are highlighted and we fail to act, we are failing to live up to our own responsibilities, and we have no right to criticise and complain about other professions not living up to theirs.
I hope that the Minister will accept the principles behind the Bill, note the strong support from both sides of the House, and favour early action.

Sir Peter Emery: It is with great pleasure that I support the Bill introduced by my right hon. Friend the Member for Wealden (Sir G. Johnson Smith). He has been fortunate in the ballot, and I congratulate him on the Bill that he has allowed me to help him bring before the House. The hon. Member for Basildon (Angela Smith) made a pleasant speech, and in reply to her worry about the ballot, I have to tell her that, having been in this place for 41 years, I have been one of the seven signatories only once. I think that my right hon. Friend the Member for Wealden, who came into the House at the same time as I did, is more fortunate, because this is his second private Member's Bill. He had a Bill on—what was it?

Sir Geoffrey Johnson Smith: Meals on wheels.

Sir Peter Emery: Meals on wheels, which is a very important service. We move from meals on wheels to health.

Sir Geoffrey Johnson Smith: I introduced that Bill at the behest of the Women's Royal Voluntary Service. I should like to thank my right hon. Friend for playing some part in this Bill. During my absence on official business, he gallantly stood in for me on First Reading: I am most grateful to him for presenting the Bill to the House.

Sir Peter Emery: That is very kind of my right hon. Friend. I think that gallantry is a slight overstatement, but I am delighted to accept it.
I shall be brief, because much of what needs to be said has already been said. I am also interested in the next Bill, the Food Labelling Bill, which would have a great effect

on my constituents, and on the farming industry in particular. I want to ensure that that Bill gets a Second Reading this time.
It is obvious that it is nonsensical that someone can escape from investigation by leaving the service and saying, "That's it. Whatever mistakes I may have made, you can't go any further in investigating what I did, because I am no longer part of the service." That cannot be right, but it obviously was not considered during the passage of the original legislation. The Bill is designed simply to ensure that, when the action of any person working in the NHS needs to be investigated, that person will not be able to escape by resigning.
Such a requirement is desirable for two reasons. First, it would assure patients—our constituents—that genuine complaints will be investigated, and that no one will be able to thwart the process by leaving the health service. Secondly, it would enable those working in the service to state that any errors or complaints will be investigated fully and properly, irrespective of whether they are still so employed. The Bill proposes to insert after "if they are"—employed in the service, that is—the words
or were at the time of the action complained of.
That simple change is proposed in paragraphs (a) and (b) of clause 1(2).
Having had to deal with private Members' Bills when I was a Minister, I can tell the present Minister that civil servants are inclined to say, "This Bill deals with a minor issue. Many other matters need tidying up. Why not say to the Bill's promoter, 'We like your idea, but perhaps you will give way and allow us to introduce legislation that covers the wider issue more comprehensively'?" Those of us who have been in the House for a long time will have heard that sort of thing from Ministers of all persuasions, and I fear that the present Government may take the same line now, although I hope that they will not.
Of course the law could be strengthened in other respects. It is obvious, for instance, that some change is needed to the General Medical Council, and greater powers of investigation may also be necessary. A number of matters that are not in the Bill, however, might be covered under its general aegis. We accept that other aspects of the health service may need to be reformed, and we would support the Government in such action, but I plead with the Minister not to ask my right hon. Friend to withdraw his Bill and wait for the Government to act.
The Minister is fairly new in her post, but I am sure she knows that getting a private Member's Bill into the Government's programme is terribly difficult, and the more minor the Bill, the more difficult it is. If the Government took the line that I have described, even the little alteration proposed by this Bill might not be made for four, five or six years. I am sure that the Minister will be able to elaborate on other matters that need to be dealt with, but I implore her to allow my right hon. Friend and the Bill's sponsors their little but, I think, important amendment to the original Act. It is simple and definite, and could, we suggest, be implemented three months after the enactment of the Bill.
The Minister would do a disservice if she postponed such action, which I think should be taken immediately—indeed, it ought to have been taken some time ago. We have the opportunity now. The Bill has all-party support and we want the Government to add theirs.

Mrs. Janet Dean: I support the Bill, but I wish that it went a little further, especially in dealing with potential problems in the private sector. It does nothing to prevent someone working in that sector from engaging in malpractice which an ombudsman would not be able to investigate.
I have another concern, which may be answered later. How long after the retirement of a doctor could an action be brought? The arrangement in the Bill seems to be open-ended. While I accept that it is vital for patients to be protected, and to feel that they are protected, I think it equally important to prevent circumstances in which a doctor, many years after his or her retirement, could be brought before an ombudsman because of an action that took place a long time ago. That loophole must be closed.
The Consumers Association has raised several issues in that context. It points out, for instance, that important information about a practitioner's performance may never come to light. That should be dealt with, especially in the light of recent events. A doctor may retire from general practice, but then work as a locum or move to the private sector, and an ombudsman will not be able to investigate. It is vital that information is available to enable a complaint to be dealt with right through to the end.

Mr. Philip Hammond: The hon. Lady mentioned the private sector. I wonder whether she was as disappointed as I was by the Government's failure to take the opportunity in the Care Standards Bill to ensure proper regulation of clinical standards in that sector. Can I take it from the tone of her remarks that she would support amendments to that Bill to bring about such regulation?

Mrs. Dean: I am sure the Government will consider that. No doubt the Minister will respond to the hon. Gentleman's suggestion later.
People must feel that they have the right to take their complaints as far as is necessary. I hope that most people, whether or not their complaints are genuine, will approach their own doctors or dentists, so that the problem can be investigated in the surgery, as close as possible to its source. We all know of cases in which medical problems have not been diagnosed as early as they should have been. In such cases, people want to know that a lesson has been learned. Although we seem to be following America with litigation, most people do not want to take such action; they simply want to be reassured that when a mistake has been made—when, for example, a medical condition has not been identified, and the patient has been put at risk—the fact has been recognised and steps have been taken to ensure that the same thing does not happen to someone else. It is the same when, tragically, someone has lost a loved one. That person wants to feel that that is unlikely to happen again—that someone has learned a lesson.
People search for answers and for reasons, especially if they have lost a loved one. Most of the time, the questions cannot be answered, but people need to be able to talk. That is probably the most important thing that doctors, dentists and others can recognise. Although loss of life is less predominant in the dental profession it does occur. People need to know that they can discuss these things and to feel that the matter has been resolved. Following

on from that, it is vital that people have confidence in the whole procedure. If the case goes ultimately to the health service commissioner, they will need to be sure that he will address the matter.
As the right hon. Member for Wealden (Sir G. Johnson Smith) has said, it may happen in only a few cases, but it is appalling to think that someone can reach the stage of submitting a complaint to the commissioner, only to be told that the person concerned has retired. After retiring, that person may still operate as a locum. People would be afraid if they thought that someone who had been brought to the attention of the commissioner was treating them as a locum.
As I say, people should have confidence in the system. They should be able to feel that, once a case reaches the commissioner, the matter will be fully investigated. I can think of nothing worse than getting to that point and then finding that the doctor has retired. They must for ever feel frustrated. We all know of constituents who come to our surgeries who experienced some tragedy 10 or 20 years ago—not necessarily medical—and who still live with it. Unless they can get to the bottom of their difficulty, they are never able to put it to one side. I go back to the point: if the matter can be resolved as close to the problem as possible, that will be far better because people are then much more likely to get over it.
Throughout the medical profession, there would be less litigation if answers could be given sooner. I know that it is a vicious circle. People are afraid of being taken through the legal system and, therefore, of answering certain questions, but I wish that we could find a way around that so that people would feel that they could respond to a patient's anxieties and concerns and answer them properly. There would then be less litigation in the first place.
As I say, I am concerned that cases should not be open ended. Someone who, perhaps, has an obsession should not be able, years later, to disrupt the life of a general practitioner who has been happily retired for five years or so. We need to address that point, so that a case is not considered a long time after the event.
However, we should also be able to close the loophole to which I referred. I am not sure whether anything can be done through the Bill, or indeed through Government legislation—although the right hon. Member for East Devon (Sir P. Emery) does not like that idea—so that we have more control of, and people have more redress over, those operating in the private sector. It concerns me that that is not dealt with in the Bill. It is incredible that the 1993 Act should be found to have such a shortcoming and that an alleged incident when someone was practising cannot be investigated. We should do anything that we can to close the loophole.

Mr. Kelvin Hopkins: It gives me great pleasure to support what is a small but important Bill. I congratulate the right hon. Member for Wealden (Sir G. Johnson Smith) on introducing it. I am one of those who remember him in his previous job as a


television presenter on the excellent "Tonight" programme some years ago. I was rather surprised to find how long ago the programme was put on.

Sir Peter Emery: Do not remind us.

Mr. Hopkins: Indeed; it reminds me of how old I am, too.
At that time, I had no aspiration to become an hon. Member, but it gives me great pleasure to debate this important issue with the right hon. Member for Wealden and, indeed, to be on the same side.
The ombudsman concept is Scandinavian in origin. It is an important concept and institution in our constitutional arrangements. It is typical that it came from that civilising region—so many of its ideas have been initiated, adopted and imitated elsewhere. As a member of the British-Swedish all-party group, I take a great interest in Scandinavian affairs.
It is important for our constituents to have the right to take complaints to an ombudsman. They are known as ombudsmen rather than commissioners. I do not know about other Members' constituents, but mine refer to them as ombudsmen, ombudspersons or whatever, rather than commissioners, even though in law they are known as commissioners, I think. It is a vital backstop for constituents to pursue their complaints.
I want to follow up the comments of my hon. Friend the Member for Burton (Mrs. Dean). Many constituents become somewhat obsessed with their problems, particularly if they are medical. They come to me, or even go to the community health council, but they do not meet medical experts who can help them. If they have the right to pursue the matter through to the ombudsman, at least they will have the benefit of professional advice and comment. Neither they nor I possess such knowledge.
Importantly, the Bill eliminates certain loopholes. As we have heard, family health service providers can go into bankruptcy or liquidation. I do not suggest that they do that deliberately—but, who knows, if they are in serious difficulty with a patient and can get away with it, they might do that. If a practitioner were of a certain age, he could choose judiciously to retire just before a problem arose, if he realised that he had made a mistake but no complaint had yet been made. He could retire before the complaint came forward, perhaps even before the patient realised that he should complain. Some professionals are clever enough to be able to use such a ruse to escape being pursued by someone who has been wronged by them. Sometimes, it is a question of incompetence or lack of effort, rather than a medical misjudgment. Nevertheless, they can avoid being pursued.
I address my remarks specifically to general practitioners. They could apply equally to dentists, opticians and pharmacists, but I am most concerned about GPs because they face the whole range of human ailments. I understand their difficulty. If one is faced with the possibility of every type of illness and condition, to make a judgment in a 10-minute consultation is difficult. I do not underestimate that difficulty and I also understand that to keep up to date with medical practice and new discoveries is difficult. Nevertheless, sometimes they still have to be brought to account for mistakes.
General practitioners work under great pressure, partly because Britain's ratio of GPs to patients is not good. We have to improve it. The Government foresee a future when the ratio is better, so that our aspiration to be the best in the world is realised—but we are some way from that goal. I am concerned about the ratio, as are many other hon. Members.
I talk about my local GPs because that is my experience. Generally, I have a very good relationship with them; they are very good GPs. I speak with them occasionally. I also have a good relationship with the members of the new primary care group. We have meetings and, occasionally, we even have dinner together—including groups of GPs—so that we can keep up to date and in touch with one another.
Nevertheless, one hears—sometimes through the community health council, but sometimes through cases brought to me personally; I am sure that other hon. Members have the same experience—of cases in which patients have not been treated appropriately. In such cases, it is very difficult for patients first, to make a judgment, and secondly, to challenge a GP. In asking a difficult question, one may put at risk one's good relationship with the GP. We all appreciate those difficulties. Those patients are able to go to their CHC or to me, as their Member of Parliament. Ultimately, however, they have to be able to go to an ombudsman.
I should like to digress slightly to deal with one point, although I think that it is legitimately within the ambit of this debate. I believe that group practices are better than single GP practices in avoiding a patient's need to visit an ombudsman. I ask my hon. Friend the Minister and her colleagues to try to persuade as many single GP practitioners as possible to join together in group practices. Group practices are a way of avoiding problems, as doctors within the group are mutually supportive and are able to consult one another if there is doubt about a patient's case.
Recently, I had a case where a patient complained about one member of a group practice, went to another member, was diagnosed with a serious condition and referred to hospital. Previously, the patient had been prescribed analgesics and told to go home to bed. A second opinion can be important, and it is quite easy to obtain one within a group practice. Moreover, within such practices there are collective pressures on doctors to ensure that care standards remain high.
Although I have no statistics to support the contention, I suspect that group practices have fewer problems than single member practices have. I am not saying that single GP practices do not do a very good job in most cases. However, there are GPs who perhaps belonged to a group practice, did not have a happy experience there, chose to go out on their own and, subsequently, have had difficulties with certain patients. Those patients need to be able to go to an ombudsman.
I suspect that it is precisely those GPs, especially if they are older, who would be able to take retirement as a way out of facing a difficult situation—to avoid dealing with the complaint of a patient who has been misdiagnosed and treated wrongly in one way or another. Mistakes are possible in the best of worlds. However, I think that group practices are better at preventing most mistakes from occurring initially, and at dealing with them if they do occur.
I have a personal experience that demonstrates that there are differences between individual members of the community. Some constituents are professionals. Some, like me, may have a scientific and even quasi-medical background. Some years ago, I went to my GP and told him that I had an umbilical hernia and needed an operation. He was slightly affronted by my presumption and said, "I'll examine you and decide what's wrong with you." He examined me and said, "You have an umbilical hernia and need an operation." In such situations, my wife calls me "clever clogs". I hasten to add that I would not presume to make a self-diagnosis in every case.
Most members of the population are not capable of making a self-diagnosis, but have to rely absolutely on their GP's word for what is wrong with them. If one is given an analgesic for a malign tumour, for example, it is a serious mistake. Pressure on GPs must be maintained. Even good professionals must be kept up to the mark and know that there is a complaints procedure that really works. They must know that there are no loopholes that will enable them to escape their responsibilities.
As I said, most members of the population—most of my constituents—are not as pompous as I am and therefore do not think that they know what is wrong with them. They depend on their GP. It is absolutely vital that, when they go to their GP, they know that they are talking to a professional who is up to the job and who will do his or her very best to ensure that they are diagnosed and treated correctly. The Bill will help to ensure that every GP behaves appropriately and professionally towards their patients.

Mr. Brian Jenkins: I congratulate the right hon. Member for Wealden (Sir G. Johnson Smith) on coming fourth in the lottery for private Member's Bills. I aspire to obtaining such a slot, but suspect that I shall have to serve in the House for another 40 years before I do so. I may not make it. The right hon. Gentleman—who has made it—has chosen to address a very sensitive issue. Although I understand why he chose it, I should like to raise a few related issues, on which I invite interventions—particularly by the Minister—if I need to be put right.
I am what is known as a cynical individual. I thought that, originally, our national health service was based on the concept that our doctors are not employees, but contractors, and that we pay them as contractors. Under that contract, complaints are dealt with on an almost commercial basis. We are able to investigate complaints about the performance of specific aspects of the contract, but only on those specific aspects. Under the contract, the patient is less a traditional consumer—a consumer is able to choose a service and decide whether to pay for it—and more a recipient of the service. The health service commissioners look after patients' rights and welfare under the contract, to ensure that we are getting a good deal. That is one of the problems.
Let us suppose, as an analogy, that a garage down the road is selling Fords, Rovers and Mercedes, that someone bought a Ford from it, and that the car turned out to have a problem. How would we feel if, when the person complained, the garage owner said, "I no longer sell Fords", and that person had no contractual right to complain directly? Patients are in that type of ball game.
I have no problem with the Bill, which starts to address that issue, but I want to know why we are not going further in amending the legislation. Like the hon. Member for Runnymede and Weybridge (Mr. Hammond), I think that regulation of the private sector should be tightened up. I am not against a nanny state, because we have a duty to protect our citizens from those who do not provide a good level of service, in whichever sphere it is provided.
Like my hon. Friend the Member for Luton, North (Mr. Hopkins), who focused in his speech on single general practitioner practices, I should like to try to put the situation in the health service in perspective. I have frequent contact with the medical profession and I see my doctor regularly. At his surgery, we often spend five minutes on my case and 10 minutes on his, as he describes problems in the health service. What are some of those problems?
When my doctor joined his practice, there had been 1,200 applicants for the post. A few years ago there was another opening for a partner, but there were two only applicants. If we are to maintain high service levels, there will have to be competition in the profession. Britain is not, however, churning out enough well-qualified, good doctors to meet our needs. We therefore have many single member practices, located primarily—although this is not written in gospel—in the poorest inner-city areas. Many capable, good doctors decide to join a group practice in the leafy suburbs and shires of England. We shall end up with a different strata of service. How can an ombudsman, or commissioner, say that the level of service is not good enough?

Mr. Andrew Dismore: I follow what my hon. Friend is saying, but as a London Member I am concerned that he does not recognise the excellent work of dedicated general practitioners in group practices on housing estates, who carry out forward-looking work and are in the forefront of developing the NHS. I suspect that some of the practitioners to whom my hon. Friend is referring may be a little behind the game.

Mr. Jenkins: I did put in the caveat that I was not speaking specifically. Of course, the more challenging work needs to be done where health needs are greatest—in poor, deprived, inner-city areas. I am well aware that emphasis should be placed on urban areas. It all may look fine on paper, but if we ask the commissioner to hound down the bad doctors, he may say, "If we get rid of the bad doctors, who will take their place?" We do not have enough doctors to go round. The statistics show that the worst covered areas are in deprived inner cities. Doctors will not want to work in those areas because the work is hard and the rewards are not sufficiently good. They would rather have an easy life.
In considering the legislation, we must ensure that the commissioner is in a position not only to name and shame, but to question the Government.

Mr. Hammond: Before the hon. Gentleman moves on from single-handed practices, I remind him that single-handed practitioners bring value to the system in sparsely populated rural areas. I am sure that he will agree that in pressing the case for group practices, for all the valid reasons that he and the hon. Member for Luton, North (Mr. Hopkins) have outlined, he would not want


that to result in denial of access in sparsely populated rural areas as people were forced to travel further to get to a GP.

Mr. Deputy Speaker (Mr. Michael J. Martin): Order. We must be careful that we do not go wide of the Bill and get into a general health service debate.

Mr. Jenkins: Thank you, Mr. Deputy Speaker. You jumped in just in time to stop me responding to that intervention. However, I totally agree with the hon. Member for Runnymede and Weybridge (Mr. Hammond) about the problems in sparsely populated areas.
I am trying to set the legislation in the context of what is possible in the real world. It is no good passing laws that are unenforceable. Not only must we close the loopholes, we must discuss the role of the commissioner and how the providers of health care should be brought into line. That includes the role of the British Medical Association and the General Medical Council.
We should ask why it is so difficult to investigate the work of a doctor. I hate to refer to specific cases, so I shall speak hypothetically of a case in which a doctor who had been culpable of the death of a young child continued to practice for more than 20 years before his right to practice was withdrawn. Why are we not getting such people out of the system? Why are they not retrained?
I am very lucky in that the GPs in my local practice have worked together closely for the past three or four years. When they become a trust, one of the doctors will have the role of a mentor. One of his functions will be to draw up the standards of his colleagues. I welcome that, but who will drive up his standards? Who will watch the watchers? The health authorities will lose power when the cash goes directly to the trusts, and when that happens who will control them? I worry that if we do not have an independent commissioner to act on behalf of the patient rather than the purchaser, we shall force people to go to the law. However, lawyers will only take a case that is winnable.
As the hon. Member for Burton (Mrs. Dean) said, we should also recognise that, on retirement, a GP should not be hounded until his dying day. There must be a reasonable time limit for investigations. However, a GP must not be placed in the position where he cannot work for the health authority or the NHS, but can continue to practice in the private sector in a practice that was purchased and built up using public moneys.
My local GP practice, as a former fundholder, was expanded using money that was not spent on patient care. The receptionist is employed by the practice. He is a contractor who gives me a ticket. I then go to a private shop where a pharmacist gives me drugs produced by a private company. The only time I meet an employee of the health service is when I go to hospital. Yet we speak as though we had a publicly run service staffed by public employees. It is not; it has always been a publicly funded private service. We must maintain safe scrutiny on behalf of the patients. At the end of the day, the commissioner must be the patients' champion.
My hon. Friend the Minister, in particular, must recognise that the Bill, welcome though it is, is only a small part of what must be a continuing programme to try to improve the delivery of a quality health service.

Mr. Andrew Dismore: I congratulate the right hon. Member for Wealden (Sir G. Johnson Smith) on securing his place in the ballot and selecting such an important subject for his private Member's Bill. Its long title goes beyond the specific matters in the legislation and raises wider issues.
Perhaps I should declare a sort of interest. Although I have never been an ombudsman, in my practice as a personal injury lawyer, I have taken a few pounds off the NHS in respect of medical negligence claims. Obviously, I have not done so since I was elected as I would not dream of pursuing my own party on such issues. Nor do I have the time to practise and be a Member of Parliament. However, my experience and that of my law firm in dealing with medical negligence cases against the NHS and the private sector provide a certain insight into how the NHS deals with complaints and how the ombudsman service works.
The reason why the Bill is so important is set out in the health service ombudsman's annual report on the health service commissioner for England, Scotland and Wales 1998–99 at paragraph 4.13 which states:
It was inevitable that the experience of the first few years of my extended jurisdiction would raise problems caused by the wording of the legislation which governs my role … A further issue on which I have expressed my concerns to the Department of Health is my inability to investigate complaints against GPs who retire or cease NHS work after the events complained of—or even during my investigation.
He stated that he was advised by his lawyers that the wording of the 1993 Act
precludes me from investigating such a complaint if the GP has left NHS work since the event complained of, and requires me to discontinue my investigation if the GP retires before or during my investigation. That occurred in two cases in 1998–99. In my view this is a clear injustice. It is unfair to complainants, and has the effect of giving GPs—and, by the same token, other FHS practitioners—immunity from investigation by me after they retire, which is not shared by clinicians employed by Health Authorities and Trusts: I may investigate their actions after they retire, in the context of a complaint against their employing organisation.
He also expresses the hope that there will be an early legislative opportunity to deal with the problem.
The words of the health service commissioner are important, because he raises the issue in detail, but the issue goes further. The right hon. Member for Wealden mentioned a case that was referred to by the Consumers Association in Which?, and the facts of that case support what he is trying to achieve. The facts bear restating, because they concern a reader, Mr. Peter Smith, who contacted Which? after the investigation into his wife's GP was dropped. Which? states:
Peter's wife, Dorothy, a retired headteacher, died from leukaemia, and Peter complained to the ombudsman that Dorothy's GP hadn't diagnosed it.
In the months before her death, Dorothy had visited her GP several times. But she was diagnosed only after she'd paid for private tests and another GP had acted on the results. Sadly, she died three months after this.
Peter had complained to the Health Service Commissioner, but the Commissioner dropped his investigation on legal advice when he discovered that Dorothy's GP had retired from his practice.


That is a scandal and clearly reveals a loophole. The Consumers Association, in its briefing on the Bill, said that it
means that … complaints, which have been deemed as worthy of investigation by the Health Service Commissioner's Office are not seen through to their logical conclusion … Important information about a practitioner's performance may never come to light while the individual practitioner can continue to treat other patients … Practitioners who are concerned about the outcome of the Health Service Ombudsman's investigation can simply retire from NHS practice as a means of avoiding having to answer for their actions—
and most importantly—
Patients are denied their right to have their complaint thoroughly considered and investigated.
The right hon. Member for Wealden referred to the actions that have been taken by the Home Office to deal with that loophole in relation to the police service, in the wake of the Stephen Lawrence inquiry. I shall not pursue that point, save to say that if it is important for police officers, it is equally important—if not doubly so—for doctors. In that context, Nick Stace, the senior public affairs officer at the Consumers Association, has said:
GPs should not be allowed to get away with avoiding complaints by simply retiring. If GPs have got something to hide, there is even more reason for the public to know. Consumers want fair treatment. This Bill is an obvious first step in achieving this.
I also contacted Action for Victims of Medical Accidents and it also supports the Bill. It said:
We welcome this Bill, which is intended to close a loophole that allows doctors to avoid investigation by the Ombudsman by retiring.
The Ombudsman does not lightly undertake an investigation—
I shall give some of the statistics on that later—
If a doctor has behaved in such a way that the Ombudsman has decided that his behaviour should be investigated it is important from the point of view of the patient or the patient's relatives that the investigation takes place. For the doctor to be able to escape being investigated simply by retiring is not only unjust but leaves the impression that doctors are not accountable.
Lack of accountability has been the major issue for patients for years … It is only recently that the Ombudsman has been allowed to investigate matters of clinical judgment … That was a major source of frustration to patients.
To those, however, who find themselves in the position where the Ombudsman actually is able to investigate, and agrees to investigate, only to have the doctor escape investigation by simply retiring, it seems a travesty of justice.
I echo those comments.
I also contacted the local medical committee in my local health service area of Barnet and it also supports the Bill. The BMA also supports the Bill, and has said:
Retiring from the NHS does not prevent the GP to continue to practise as a locum—a temporary stand-in doctor—or to practise privately.
That is an important point when one considers the role that locums play in the NHS, especially in the inner cities—as my hon. Friend the Member for Tamworth (Mr. Jenkins) pointed out—in covering overnight care. GPs are run off their feet during the day and house calls at night are often done by locums or contracting services brought in by the GPs. Often, locums see patients in great distress, at times when they might not be entirely clear in their descriptions of their symptoms. The locums also do not know the patients' histories, and one of the great strengths of our family doctor service is the continuity that comes from the same practice looking after the same family for generation

after generation. That can break down if a locum is called out to cover for illness or holiday, or to provide overnight care. There is, therefore, a greater risk that problems may arise with locums.

Mr. Jenkins: If a locum has no access to individual records and is called out, as part of a commercial activity, and then makes a mistake because of the lack of access to those records, is his competence or the system in question?

Mr. Dismore: Both would possibly be in question, but we have to be realistic. As it becomes more common for records to be computerised, we may have an answer to that problem, but it is inevitable that locums will be used. My concern is not the competent locum, who will bear in mind the conditions in which he has to operate—which may include not having a complete medical history—but those doctors who have retired from the NHS to avoid an inquiry by the ombudsman and who still practise as locums. Their competence may be in question, as well as their ability to operate in the circumstances that I have described.
It is important that the BMA welcomes the Bill. It supports the initiative
to ensure that a complaint against a GP could be investigated regardless of whether or not the GP retired from the NHS and to remove the loophole through which GPs can evade investigation. Information as to the performance of the doctor revealed in the investigation would assist in the assessment of the GP as part of the revalidation process and as part of any investigation by the General Medical Council.
My hon. Friend the Member for Burton (Mrs. Dean), who is no longer in her place, made an interesting point about time limits, which are not addressed in the Bill. While I understand the point made by her and my hon. Friend the Member for Tamworth, we must proceed cautiously. When considering the complaints procedure in the NHS, of which the ombudsman forms part and which the Bill aims to improve, we need also to consider the relationship between the complaints procedure and clinical negligence cases. If the time limits for complaints are less generous than those set out in statutory and common law, we run the risk of throwing the baby out with the bath water, in that the only remedy then available to the patient who wanted to make a complaint after the time for complaint had run out would be to go to law. I am sure that we all agree that it would be better if we could devise a system that satisfied complaints without recourse to law.

Mr. Jenkins: It is one thing to have a time limit of, say, six years, but a catalogue of events may stretch back 20 years. Memories fade and records are not necessarily kept, so justice cannot be achieved after such a long time.

Mr. Dismore: I do not wish to start a peroration about the way in which the limitations legislation works, because that would stretch your patience a little too far, Mr. Deputy Speaker. However, I still keep up to date by reading the law reports in the quiet hours while waiting for late-night votes and many cases involve interpretation of the law on limitations. While we have a standard bar of three years for bringing a claim, there are many exceptions and it is important that those exceptions are translated into any complaints procedure in the NHS. The


most important exception is the date of knowledge exception, because people may be injured by an incompetent doctor but not know that they have been injured until several years later when the symptoms re-emerge. We read frequently of cases in which patients have been troubled by something for several years and they are opened up and it is found that a bit from some previous operation had been left inside them. There is no way for patients to know about that, as they are unconscious during operations. All they know is that there is something wrong with them. We have to be careful about introducing time limits, and the limits set out in the legislation are the ones that should be introduced into the ombudsman process. Serious problems could arise if we were to do otherwise.
My main problem with the Bill is that it does not go far enough. The reports from the health service commissioners and from the Select Committee on Health, which has examined the matter over several years, point out serious problems with the original Health Service Commissioners Act 1993. Its most serious loophole was that it placed clinical negligence outside the complaints procedure. That loophole was closed by the Health Service Commissioners (Amendment) Act 1996, but many problems remain. I hope that we will be able to plug more of the loopholes in the 1993 Act as we consider this Bill in Committee.
The Bill has an ambitious long title. It is to
Amend the Health Service Commissioners Act 1993.
That ambition is let down somewhat by the modesty of the amendment that it proposes. However, the scope of the long title would be sufficient to allow the concerns expressed by hon. Members of all parties to be addressed.
On 7 December 1999, GP magazine highlighted one of the problems of the existing system. It reported:
the Medical Defence Union's deputy head of advisory service, Dr. Patrick Hoyte, said the powers of the NHS ombudsman were so weak it was unlikely a GP would feel compelled to retire to escape a ruling.
He told GP: "The ombudsman can only name and shame. How much of a sanction that is is debatable. I'd be surprised if a GP would think of retiring to avoid an investigation.
I think in cases where GPs have retired it may be purely coincidental.
That may or may not be true, but the Medical Defence Union gives the game away when it states that the ombudsman has very few powers. The Bill may catch one or two more doctors who could be named and shamed, but it will not solve the problems of most of the patients who resort to the ombudsman.
The quotation in GP magazine is instructive. The Medical Defence Union's job is to insure doctors against clinical negligence claims, and it has done more than any other body to obstruct complaints being brought and satisfactorily disposed of. It tells doctors to be careful about what they say to patients for fear of compromising their legal position. It fights medical negligence cases tooth and nail and strings them out for years. It is part of the problem, not the solution. By rubbishing the ombudsman service in that way, it is ensuring only that there will be more work for the insurance companies, for whom more complaints brought through the courts mean more trade.

Sir Geoffrey Johnson Smith: I respect the hon. Gentleman's wisdom, gained as a practising lawyer in this field, but I hope that he is not suggesting that the Bill should be dropped because it does not go far enough. Wider reform would be a matter for the Government, but we must get our priorities right and deal with what we know we can deal with. The Bill has raised no objections and is a modest but significant improvement on the 1993 Act. We should not wait for the grand legislative scheme that he is beginning to outline. It is hard for me to swallow the concept of waiting and throwing the Bill out at this stage. I cannot foresee the Government including the provision in a Queen's Speech, given that there is already a long waiting list of measures bidding for recognition by the House of Commons.
I hope that the hon. Gentleman will agree that whatever modest change the Bill may make should go ahead, and that we should not spend a great deal of time trying to do what we know the Government one day may wish to do.

Mr. Deputy Speaker: Order. The right hon. Member for Wealden (Sir G. Johnson Smith) has made an important point. The Bill before us is a very narrow piece of proposed legislation, and it is determined by its title and by its contents. The hon. Gentleman is looking at matters that could be amended at another time, and I remind him that we can consider only what is before us this morning.

Mr. Dismore: Thank you, Mr. Deputy Speaker. However, the Bill's long title states that the aim is to amend the 1993 Act. That is very ambitious, and I believe that it would be in order for us to table amendments in Committee to deal with the shortcomings in the existing system identified by me and other hon. Members.
I have no objection to the Bill. I support what the right hon. Member for Wealden is trying to achieve. However, the long title permits us to address other issues by means of amendments to the Bill in Committee.

Mr. Deputy Speaker: Perhaps I can assist the hon. Gentleman. As I mentioned, the Bill's scope is determined not only by its title, but by its content. He must confine himself to the content of the Bill.

Mr. Dismore: I am grateful, Mr. Deputy Speaker.

Mr. Hopkins: I am slightly worried by something that my hon. Friend the Member for Hendon (Mr. Dismore) said. Will he say whether problems could arise at the interface between the areas covered by the Bill and the legislation that it amends, and the areas that are not? Is it not important to ensure clear definition so that the Bill's scope is as wide as possible? If the limits of its application are blurred, people might be able to evade its provisions.

Mr. Dismore: That is an important point. We have to look at the role of the ombudsman, which is clearly set out in his report. He states:
My core role as Health Service Ombudsman is to deal with complaints. My office is not at core an audit or educational body, although we do a lot of work to feed the outcomes of our work into those important areas.


The ombudsman is part of a much wider NHS system of dealing with complaints, and we have to see his role in that context.
I shall not test the House's patience by going through the whole NHS complaints procedure, but we must understand why people get frustrated when they bring a complaint against a GP who has retired or who goes on to retire. Before the ombudsman can get involved, the internal complaints procedure has to be exhausted. One of the problems with the internal complaints procedure is that it takes so long.
The first stage of the internal procedure is the local resolution, under which the health authority trust and the relevant primary care practices are required to establish procedures for investigating and resolving complaints. If that process fails, the second stage is the independent review panel. Patients and carers who are not satisfied with the outcome of local resolution are entitled to request an independent review to consider the complaint. If they make that request, the complaint is reviewed by a convener, who is usually a non-executive director of the relevant trust or authority.
Patients who are still not satisfied can refer the matter to the health service commissioner. The Bill seeks to solve the problem of GPs who retire before a complaint to the ombudsman can be determined.
It is my experience, and I am sure that it is shared by hon. Members who have had to deal with complaints against doctors, that the NHS internal complaints procedure can take many months to grind through the various stages. For example, I was told about the case of a woman who underwent a biopsy on her cervix, having been assured that it would not affect her fertility. The procedure was not properly carried out and in fact they sewed up her cervix. She was not happy: she obtained the medical records, made a complaint, the trust said that it had lost the records, she sent it copies, there was a lot of delay, no meetings were offered, the trust would not agree to an independent review, she lost faith and she litigated the case.
If it takes perhaps a year before a case even reaches the ombudsman and the ombudsman then takes another year to investigate it, the general practitioner concerned could have died of old age, never mind retired, by the time the case is concluded. We must examine the way in which the ombudsman looks into the complaints procedure. The point was made that GPs would retire anyway. They may not be doing it to avoid litigation or a complaint, but we must bear that eventuality in mind. If the complaints procedure takes for ever to exhaust, retirement before a conclusion is reached is likely to occur.
The other problem that may motivate GPs is the appalling attitude that doctors sometimes exhibit when complaints are made against them. They try all sorts of tricks to avoid complaints, which is regrettable. In his report, the ombudsman stresses—

Mr. Oliver Letwin: I have been listening with fascination to the hon. Gentleman's remarks. As I have the impression that he may be intending to continue for some time, and I know from experience that his energy is almost inexhaustible, could he give us an estimate of how long he intends to continue wittering?

Mr. Deputy Speaker: Order. It is not for the hon. Gentleman to concern himself about how long another hon. Member speaks. As long as he is in order, he is entitled to speak.

Mr. Dismore: I am grateful to you for your protection, Mr. Deputy Speaker. I was talking about the attitude of doctors to complaints and the tricks that they sometimes try to avoid liability.

Mr. Hammond: As the hon. Gentleman is making a point about doctors' attitudes, does he think that doctors are different in that respect from other professionals, particularly lawyers?

Mr. Dismore: I think that there are good and bad in both professions. I would be out of order if I digressed about the way in which the Law Society is, or is not, trying to clean up its act. Reputable legal practices—including, I hope, my own—have proper complaints procedures, as required by the Law Society. They view complaints in the correct light—not as something to be frightened of, but an opportunity to work out what went wrong, put it right, learn from experience and improve the processes. Some doctors, however, do not regard complaints in that light, although the ombudsman made it clear in his report that he thought that the British Medical Association—the profession—viewed complaints more constructively.
I should like to answer the hon. Gentleman's question by quoting something from the magazine Pulse. It was said by the chair of the local medical committee in the constituency of the right hon. Member for Wealden and is revealing about his attitude towards complaints. Dr. Ted King was commenting on the Bill and I think that he was having a bit of a pot at the right hon. Member for Wealden, quite unfairly. Dr. King said, in opposing the Bill, that the mood was more about revenge than justice. He said that serious complaints could still be pursued by patients through the civil courts, so patients would mainly use the new law to pursue trivial grievances. Dr. King said:
Most complaints are not serious—there is a large revenge element which occurs when patients don't get what they want.
Those comments were made directly about the Bill.

Mr. Deputy Speaker: Order. I think that the hon. Gentleman is going wide of the debate before us. He cites cases of neglect or possible neglect, but the Bill deals specifically with doctors who seek to retire after a charge is made against them. That makes it a very narrow matter indeed.

Mr. Dismore: Thank you, Mr. Deputy Speaker. I referred to that quote because it shows the right hon. Member for Wealden's own local medical committee having a go at the Bill and, presumably, indirectly having a pot at him. I am sure that he is far too clever a politician to have a go at the doctors in his constituency, but I do not see why I cannot at least answer on his behalf.

Sir Geoffrey Johnson Smith: I am surprised that anyone should wish to have a poke at me on this subject. I have always enjoyed very close and friendly relationships with the medical profession in my


constituency and elsewhere. Two members of my family are doctors, by the way, but that has nothing to do with the Bill.

Mr. Dismore: I assume from what the right hon. Gentleman says that neither of them are close to retirement.
My point goes back to what I was saying regarding the Medical Defence Union. If the ombudsman's service is to operate effectively and people are not to avoid liability by using the loopholes that exist and those identified by hon. Members, there will have to be a sea change in the way in which some—not all—doctors, approach complaints.

Mr. Hopkins: A propos the recent comments made by Conservative Members, may I say that I am finding my hon. Friend's speech particularly interesting and illuminating? Within the scope of the debate, I hope that he will make every point that he has at his disposal, because I am learning a lot from listening to him.

Mr. Dismore: I am grateful to my hon. Friend. If I stray too widely from the matter before us, Mr. Deputy Speaker, I am sure that you will bring me back to order. Perhaps I will be able to fill in the gaps for my hon. Friend in the Tea Room afterwards. The Bill raises important points, and I have striven to put it in context. We cannot look at the health service ombudsman without looking at how complaints first arise.
The BMA's efforts in continuing education and re-evaluation are important in this context. If I may refer to the recent intervention of the hon. Member for Runnymede and Weybridge (Mr. Hammond), my profession is concerned to ensure that lawyers have continuing education and keep themselves up to date. We have put in place all sorts of measures to achieve that. I am pleased that the BMA has recognised the need for re-evaluation of doctors.

Mr. Deputy Speaker: Order. The hon. Gentleman is again straying from the scope of the Bill.

Mr. Dismore: Doctors who will be retiring because they are coming to the end of their life in practice are the most likely to require re-evaluation and retraining. That is why I think that what the BMA said is important.
You have told me clearly, Mr. Deputy Speaker, that you are not minded to allow me to deal with some of the wider issues that have been raised in the debate by other hon. Members. I had hoped to be able to say something about the problems of private medicine. Other hon. Members managed to get away with it, but I get the impression that I will not.
I turn to the important issue of sanctions. The ombudsman's service, as presently constituted, does not have the powers that it needs to deal effectively with cases. We heard earlier that it was pretty much a toothless tiger: all it can do is name and shame. If a GP retires and is not in practice, naming and shaming will not make much difference to him. I hope that, if the Bill proceeds to Committee, one of the issues that we shall discuss is the sanctions that can be imposed.

Ms Bridget Prentice: The sanctions that the commissioner can impose are important to the

public and how they respond to his remit. Has my hon. Friend any idea as to what sanctions might be appropriate given that, for the patients concerned, what is often most important is that their grievance has been aired, listened to and dealt with positively by the commissioner?

Mr. Deputy Speaker: Order. The provision of sanctions is not raised by the Bill.

Mr. Dismore: That is a very serious omission, but I shall not try your patience, Mr. Deputy Speaker, further.
Sanctions are not just a question of securing an apology or an ex gratia payment. They are important for doctors who, by retiring, try to avoid the liabilities that might attach to them. That point is addressed in paragraph 4.6 of the ombudsman's report.

Mr. Jenkins: My hon. Friend mentioned the length of time that it takes for an internal inquiry to happen and trigger the point at which the ombudsman is brought in. That time might allow the GP to come to arrangements regarding his retirement decision. If my hon. Friend is lucky enough to serve on the Committee considering the Bill—I doubt whether he will be—will he press the Minister to ensure that the ombudsman is brought in much earlier? People do not think that they will get justice if a doctor judges a doctor who judges another doctor and the process is made to drag on until the ombudsman, whom the public regard as their champion, is introduced.

Mr. Deputy Speaker: I shall certainly not be taking part in the Committee.

Mr. Dismore: My hon. Friend makes a valuable point about the way in which medical complaints are investigated. However, I get the feeling from your previous remarks, Mr. Deputy Speaker, that you will not permit me to go down that route. Perhaps that is unfortunate.
The health service commissioner's report makes an important point about when an investigation is kicked off but he does not follow it through. This is one of the ills that the Bill aims to address. In paragraph 4.6 of his report, the commissioner says:
During 1998–99 there were other occasions in which complaints to me raised issues which I thought appropriate to pass to the regulatory authority concerned, because there was a possible risk to the health or safety of patients.
That is one of the points with which the Bill deals. He adds:
However, the effect of the wording of the legislation governing my role is to restrict the circumstances in which I can pass such information to another organisation, such as the GMC or the Commission for Health Improvement. For example, I cannot disclose information to another organisation if I decide not to investigate the complaint, or if the matter of concern falls to be disclosed in one of my reports.
The Bill deals with doctors who retire, and that relates to the circumstances that the commissioner has described when his investigation cannot continue.
The ombudsman adds:
As a result, paradoxically, I have less scope to bring concerns to the GMC, for example, than a private citizen has. And my medical and nursing advisers are in a potentially invidious position if they consider that they have a professional duty to act on concerns arising from their scrutiny of a complaint to me.


That is a particular ill with which the Bill seeks to deal in relation to GPs who retire, but only in so far as the investigation can continue. If the ombudsman decides for some reason that, after starting to investigate a complaint, he will not continue with it, he might not refer that information on to the General Medical Council or the Commission for Health Improvement.

Mr. Tony McWalter: I am bit concerned by my hon. Friend's use of the word "retire". A doctor aged 30 could easily retreat into the private sector while the heat was on. After the inquiry has been dropped, there is no reason why he should not return to the health service. I do not want my hon. Friend to give the impression that the provisions apply only to elderly doctors who have begun to get slack.

Mr. Dismore: I am grateful to my hon. Friend. I would have liked the opportunity to comment on private medicine, but given the views that you, Mr. Deputy Speaker, have expressed, I suspect that you will not allow me to go down that route. However, other Members have raised that point.
We need to consider what people expect from the complaints procedure against a GP who has retired or one who has gone into private medicine, and the Bill will deal with cases involving GPs who retire. People expect to have their complaints properly and promptly investigated. They want to know what happened and they want to be sure that it will not happen to anyone else. Many of the problems that result in claims for medical negligence would disappear if we could create a system in which complaints are investigated and the doctors concerned apologise.
I can give an example from my own experience. I was a victim of medical negligence myself. I had to have an injection in a shoulder for a tendon problem. When I see a doctor in hospital I have always made it clear what I do for a living just to keep him on his toes. However, we became so involved in discussing that issue that the doctor injected the wrong shoulder—a classic example of getting the wrong limb. He immediately explained what had happened, what the effects would be, said that he was sorry and that was the end of the story. I have suffered no long-term ill effects—as far as I know anyway. The approach taken by that doctor is what we are trying to achieve by having a more effective complaints procedure in which the ombudsman is the pinnacle of the process.
The Bill may have implications for resources. We know from the ombudsman's report that the number of cases that he investigates is not that great compared with the total number of complaints that he receives. In 1998–99, he received 2,869 complaints, of which 119 were investigated. Of the 119, roughly half the complaints62—were about clinical matters. His report suggests that two or three of those complaints would have been caught by the Bill, so quite a few complaints could be investigated under it.
I am concerned about the principle of quis custodiet custodes and making the ombudsman system work effectively. His report illustrates graphically the length of time that he takes to deal with complaints. I am concerned that the Bill may increase his work load to such a degree that he cannot deal with complaints effectively.
The end of the report deals with the number of cases and investigations that the ombudsman has handled. It takes up to a year—three or four years ago, it took even longer than that—to deal with a complaint and that simply undermines the whole system. If the Bill adds to his work load—he investigates only a small proportion of the total cases involved—even by only 10 or 20 cases and the resources are not there to enable him to do his job effectively, it will have a knock-on effect on other cases and the undesirable consequences that I described earlier. The complaints process will take longer, people will become unsatisfied and they will resort to law as the only recourse left open to them.
We need to ensure that the public have confidence in the complaints procedure. To do that we have to ensure that it is timely and effective. You, Mr. Deputy Speaker, have prevented me from describing the ways in which the present system is not effective because it has no teeth. There are gaping loopholes in the Bill in relation to private medicine and Members on both sides of the House have referred to that. There are also many other problems, such as the lack of co-ordination between social services and the NHS.
Although the Bill deals with one small loophole, we should take the opportunity to address the wider issues. I am pleased that in response to the request from the health service ombudsman, the Government set up a wide-ranging review of public sector ombudsmen. That was done in March 1999, following the submission of a paper to the Government—

Mr. Deputy Speaker: Order. I cannot allow the hon. Gentleman to continue that point. I remind him that Standing Orders of the House give the Chairman powers to prevent him from continuing in this manner, and he is getting close to the point at which I will invoke them.

Mr. Dismore: I am grateful to you, Mr. Deputy Speaker. I was just about to conclude my remarks, which may cause relief to many.
I say to the right hon. Member for Wealden that although I welcome and support his Bill, it will not solve the problems of the ombudsman. The real answer to those problems is the conclusion of the review that the Government have set up to deal with all the problems of ombudsmen generally, including co-ordination.

Sir Geoffrey Johnson Smith: Whatever the truth of that, the hon. Gentleman will agree that in the meantime we might as well take what is on offer and pass the Bill, and the Government can deal with the wider scheme much later. The Bill will not upset the Government's programme and does not contravene anything that they have proposed. I hope that if he cares to serve in Committee, the Bill will receive his support there.

Mr. Dismore: I said at the beginning of my speech that I have no objection to the Bill. It is worthy, but it is very little, and although its title is ambitious, the Bill will not fulfil those ambitions. I wish the Bill good luck in its remaining stages, but we will eventually have to address the other issues. I would be satisfied if the Minister, in her response to the debate, indicated that the Government will introduce much broader proposals very soon. If that process is going to take a long time, the right hon. Gentleman has a valid point.

Mr. Philip Hammond: I shall be brief. Listening to the hon. Member for Hendon (Mr. Dismore), I often have the impression that no one has told him that in this place, unlike in his previous profession, there is no meter ticking and he is not being paid by the hour.
I congratulate my right hon. Friend the Member for Wealden (Sir G. Johnson Smith) on securing his place in the ballot and introducing this small but important Bill. We are dealing with a simple solution to a narrow problem. The hon. Member for Hendon suggested that the work load of the health service commissioner might explode as a result of the Bill, but he was being disingenuous. Very few cases are affected by the loophole that my right hon. Friend has identified. The hon. Member for Luton, North (Mr. Hopkins) described the health service commissioner as a backstop provision, after other mechanisms for dealing with complaints in the health service have failed. The Bill will therefore affect only a few people.

Mr. Jenkins: Although I accept that the Bill will affect only a few people, my concern is that the commissioner's existing work load is such that those few cases will lengthen the time in which cases are dealt with, as my hon. Friend the Member for Hendon said. We need to put in extra resources to ensure that that does not happen.

Mr. Hammond: I suggest that on resourcing the hon. Gentleman addresses the Minister.
To return to my point, although only a small number of people will be affected, at the moment those people are deprived, through the loophole, of the pursuit of justice. My right hon. Friend has introduced the Bill to remove that sense of injustice.
As hon. Members on both sides of the House have noted during the debate, this issue is, in broader terms, gaining increasing public awareness. There is the question of police officers who retire and avoid being pursued by the proper mechanisms for dealing with maladministration or misconduct. We amended the Protection of Children Act 1999, during its passage through the House, to ensure that it dealt not only with those whose misconduct was detected while they were employed, but with those whose crimes or misdemeanours were detected after their employment ceased. This Bill is riding a tide of public awareness.
The health service commissioner himself has drawn attention to the loophole, as the hon. Member for Hendon explained at some length by quoting from the commissioner's report. The problem arises because, unlike the secondary health care service—our hospitals—where the institutions are enduring and do not depend on the presence of individuals, most of our primary care services are provided by independent contractors, as the hon. Member for Tamworth (Mr. Jenkins) pointed out. Although primary care is publicly funded, the services are effectively privately provided. That means that when providers of general medical, optical and dental services retire or cease to offer those services to the NHS, they cannot be pursued by administrative mechanisms.
One of the objections to the Bill which has been mentioned by more than one hon. Member is relevance. It is suggested that because the health service

commissioner has relatively blunt teeth, it is not conceivable that doctors would retire deliberately to avoid sanctions that are not very onerous. That misses the point. My right hon. Friend the Member for Wealden is suggesting not that doctors will retire for the explicit purpose of avoiding justice at the hands of the health service commissioner, but simply that when doctors retire or move out of the NHS, perhaps for reasons unrelated to complaints, those who are pursuing complaints may feel that they have been denied natural justice. Closing the loophole will address that.
There is a wider issue of the effectiveness of the health service complaints procedure and the question of whether the commissioner needs stronger powers. As my right hon. Friend the Member for East Devon (Sir P. Emery) said, those concerns, legitimate though they are, are no excuse for inaction when in this private Member's Bill we have the opportunity for action without any cost to the Government's legislative time.
My right hon. Friend the Member for Wealden and other hon. Members have drawn attention to questions about the role of the General Medical Council and the possible extension to the private sector of procedures for dealing with complaints and medical malpractice issues. Although we cannot debate that this morning, clearly there is a need for properly regulated mechanisms in the independent sector to ensure that patients are treated safely and properly, whether they choose to get medical treatment in the NHS or the private sector. It is the Government's primary responsibility to ensure a safe framework within which patients may make that choice.
I hope that the Government will in time recognise that and examine the health sector with the same evenhandedness with which they now propose to examine the residential and nursing care sector in the Care Standards Bill. Under that Bill, regulation of local authority and private sector provision will, for the first time, be placed on an even basis.
There is clearly a balance to be struck between the public's right to protection and the profession's need to self-regulate. Self-regulation must be seen to be working, and the hon. Member for Basildon (Angela Smith) made an important point about public confidence. It is in the public interest and that of the professions themselves that self-regulation works properly and is seen to do so. Even with proper, effective self-regulation, there will be a role for the health service commissioner as the final tier of the administrative complaints system in the NHS.
My right hon. Friend the Member for Wealden has made modest proposals to deal with a problem that is highly specific, glaringly obvious, not very widespread, but none the less important. The Opposition will be sympathetic to Government proposals to improve the health service over time, but whatever the Minister can tell us today about the Government's wider intentions in the long-term should not be used as an excuse for inaction now. I hope that the Government are minded to allow my right hon. Friend's Bill to proceed to Committee for more detailed examination.

Mr. Alan Williams: I shall be brief. I am one of the Bill's supporters and I congratulate the right hon. Member for Wealden (Sir G. Johnson Smith) on introducing it.
Having served with him in Committee and during late-night sittings in the Chamber, I have great admiration for the hon. Member for West Dorset (Mr. Letwin). I admire his assiduity and the breadth of his parliamentary interests, but I seem to recollect that the length of his speeches is subject to a singular elasticity. If longevity becomes a punishable offence, he will face a lifetime ban from the House.
The subject of the Bill mirrors the frustration experienced by members of the Public Accounts Committee on numerous occasions when we have dealt with the national health service. I do not say that there is anything wrong with the trust structure of the NHS, but because of that structure incompetent, inefficient senior administrators who have failed need not leave the health service. All they have to do is leave one trust and move to another, picking up their severance pay on the way. Thus, they escape any penalty and avoid any risk of dismissal from the health service.
The target for which the right hon. Member for Wealden aims is a modest one, but it needs to be hit. The practice of using retirement as a means of evading accountability is well understood in this country's police forces, nowhere better than in the Metropolitan police, as the PAC discovered. The problem is greater in other spheres than the health service, but it must be addressed wherever it exists.
The issue of unfairness has been debated, and I shall not repeat points on which we all agree. One of the trends exacerbated by the problem is the greater use of litigation. I am not one of those who deplores the use of litigation in connection with the health service. I have sat through numerous inquiries into failures of the health service, although I should add that it has also had many successes. Nevertheless, the fact that litigation has become an appropriate response has to be deplored.
Many people are driven to the law because of the inefficiency and ineffectiveness of the current systems, both in the NHS and the medical profession generally. Because the NHS has failed and the profession refuses to address the problem correctly, we have been forced down the American route, whereby litigation has in many cases become the sole outlet for the dissatisfaction and frustration felt by many of our constituents. We in south Wales have recently had the experience of a local man—not a constituent of mine—dying in a Swansea hospital after the wrong kidney was removed. That should not have happened. When such things happen, there must be accountability. There has to be justice for the family.
I am sorry that my hon. Friend the Member for Hendon (Mr. Dismore) has left the Chamber, because I wanted to issue a caution to him in connection with private Members' Bills. Mr. Deputy Speaker, you know that I would never challenge your judgment on debate in the Chamber. However, as we are always told when we attempt to raise Committee matters on the Floor of the House, certain matters are for the Committee to deal with. The Chairman of the Committee might use his discretion to allow a far wider debate of the matter in hand. I caution my hon. Friend against attempting to exploit that in terms of amendments to the Bill.
All my experience as a Member of Parliament leads me to believe that the wider a private Member's Bill's scope, the less chance it has of reaching the statute book. In my 36 years in the House, I have never drawn number one in

the ballot. We all dream of getting a great private Member's Bill passed, but only a few such Bills—four or five—are passed in the lifetime of a Parliament, and those only get through when the Government provide extra time. A private Member's Bill that goes the normal parliamentary route stands a far greater chance of reaching the statute book if it is well focused and kept within the minimum scope necessary to achieve its intended objectives.
If my hon. Friend becomes a member of the Committee, I encourage him to use whatever breadth the Chairman allows to air broader issues relating to the commissioner, but he should not attempt to insert extra provisions in the Bill that would make it far harder to get through Report, which is extremely limited and easily sabotaged.

The Parliamentary Under-Secretary of State for Health (Ms Gisela Stuart): I welcome the opportunity to debate the important issues raised by the Bill introduced by the right hon. Member for Wealden (Sir G. Johnson Smith). The role of the health service commissioner is extremely important. Although the national health service has procedures for dealing with complaints, there are inevitably some cases that even its best endeavours cannot resolve to the complainant's satisfaction. When that happens, the commissioner provides an essential additional option for complainants, who might otherwise be left without the assurance that their complaint has been taken seriously and thoroughly investigated.
We have heard several useful contributions this morning; I shall refer briefly to some of them. My hon. Friend the Member for Basildon (Angela Smith) expressed doubt about the wisdom of congratulating those who draw numbers high up in the private Members' ballot on their achievement. I am reminded of Napoleon's response on being told about the abilities of one of his generals: he asked, "But is he lucky?" We all know that both ability and an element of luck are needed for success in politics. I therefore congratulate the right hon. Member for Wealden on his luck and join my hon. Friend the Member for Basildon in congratulating him on his choice of Bill.
My hon. Friend is a supporter of the Bill, as are many eminent right hon. and hon. Members on both sides of the House and some outside organisations. My hon. Friend raised the question of the review of the complaints procedure as a whole. That takes us outside the remit of the Bill.
With great charm, the right hon. Member for East Devon (Sir P. Emery) offered a caution about civil servants who might advise Ministers that, although the Bill is worthy, more can be done at a later stage, so it is best to do nothing now. That is the civil service rephrasing of "God, make me virtuous, but not yet." I hope that my colleagues and I will be able to resist temptation. The right hon. Gentleman also reminded the House of a previous achievement of the right hon. Member for Wealden. His contribution may be regarded as small, but he helped many older people and NHS patients by broadening access to meals on wheels. Today's Bill follows in a good tradition.
My hon. Friend the Member for Burton (Mrs. Dean) raised the important issue of time limits, to which I shall return later. In that context, she raised the question of


clinical standards in the NHS and in the private sector. It is important to realise that the NHS is a managed service, whereas the private sector is regulated. Thorough regulatory powers introduced in the Care Standards Bill will ensure, using various methods, that proper clinical standards are observed.
My hon. Friend the Member for Luton, North (Mr. Hopkins) paid tribute to the ombudsmen and reminded us of some of the other enlightened developments from the Scandinavian countries. He was correct to point out that we have among the lowest general practitioner complements in Europe, and we therefore need to train more doctors. I am delighted that he intends to support the Government in that, rather than suggesting that we should all follow his example by diagnosing our own illnesses.
My hon. Friend the Member for Tamworth (Mr. Jenkins) questioned whether control and regulations could be taken wider. I tend to agree with other hon. Members who have commented that the fact that this is a small measure should not be allowed to detract from its contribution to ensuring better services. The Bill should be seen in a wider context.
I am delighted that my hon. Friend the Member for Hendon (Mr. Dismore) is now using his considerable legal skills to support the House and the Government, rather than pursuing medical negligence cases. Even though that will deprive some members of the public of his skills, I believe he does a much better job in this place. He raised the issue of sanctions and raised one concern which I shall take the opportunity to put right.
The commissioner has in the past expressed concern about his inability to pass information to other bodies. That problem was resolved in the Health Act 1999, which amends the Health Service Commissioners Act 1993. Since October 1999, the commissioner has been able to pass on information when he considers it necessary in the interests of patients' health, safety and welfare.
Finally, I express my thanks to my right hon. Friend the Member for Swansea, West (Mr. Williams) for sharing his considerable experience of how to ensure the success of private Members' Bills. I congratulate him on being a sponsor of the Bill.
On the issue of other professionals, my right hon. Friend may be interested to know that, with regard to possible disciplinary action against police officers following retirement, the Home Office is taking the matter forward in the light of recommendations made in the report on the Stephen Lawrence inquiry. I hope that we not only aspire to being a joined-up Government, but will show that that can be achieved.
Returning to the substantive matter of the Bill, may I take the opportunity to put on record the Government's admiration of, and gratitude for, the work of the commissioner and his office? Many of the speakers this morning confirmed my experience as a constituency Member. We are often faced with distressed or desperate constituents who come to see us as their last chance of getting their problem, whatever it may be, sorted out. We all know that it can take all our reserves of tact and sensitivity to deal with such situations, yet the commissioner's officers face them every day, and it is important to acknowledge the effort and commitment that that demands.
It may be useful to give a little background to the present situation. Until April 1996, the health service commissioner could not investigate complaints about family health services practitioners—that is, general practitioners, family dentists, pharmacists and opticians. They were explicitly excluded from his jurisdiction. Nor could he consider complaints about matters of clinical judgment, and the extent to which he could look at complaints about independent providers of health care to NHS patients was limited.
That changed in 1996, when the current NHS complaints procedures came into force. In parallel with those reforms, and in order to provide a consistent system for all NHS patients, the Health Service Commissioners (Amendment) Act 1996 extended the jurisdiction of the commissioner to bring family health services providers, and complaints involving clinical judgment, within his remit. It also removed the limitations on his capacity to investigate independent providers.
The widening of the commissioner's remit represented the biggest change to his jurisdiction since the role was originally established. For the first time he was, and is, able to investigate complaints about any aspect of NHS treatment and services, regardless of where or how it was delivered. No one should underestimate the importance of that.
Nevertheless, as the right hon. Member for Wealden explained, there is a loophole in the wording of the 1996 Act. Sections 2A and 2B have been interpreted as requiring that the individual or organisation being complained about must still be providing NHS services at the time of the commissioner's investigation. If they are not, they are outside his jurisdiction. I understand from the commissioner's office that there have been a few cases where he has felt obliged to accept legal advice that he could not investigate a particular complaint because the practitioner involved had ceased to provide NHS services.
The right hon. Member for Wealden seeks in his Bill to plug that loophole by amending the wording of the 1996 Act so that, for example, retired GPs, or independent providers who have sold up, will remain subject to investigation by the commissioner.
I have considerable sympathy with the right hon. Gentleman's view on that. I also know that the commissioner himself has expressed concerns about the situation. Not only has he written to officials in the Department of Health, but he raised it in his annual report for 1998–99. I agree that it seems intrinsically unfair that complainants should not be able to pursue their concerns simply because the person about whom they wish to complain has retired. I understand also that it could be seen as a way for recalcitrant practitioners to avoid facing up to their responsibilities.
I should like to believe that the vast majority of practitioners would never behave in such an unprofessional manner, but I suppose the reality is that some will, given the opportunity offered by the loophole. Moreover, there is a further element of unfairness in that it is not a problem in the hospital sector, because it is the hospital trust as an organization which is the subject of the complaint, not a particular individual in it. Thus the commissioner can investigate even if the clinician involved has retired, left the country, or whatever. It does not seem right that a complaint involving a retired hospital doctor can be pursued while one about a retired GP


cannot, so I understand and sympathise with what the right hon. Member for Wealden is trying to achieve in his Bill.
Opponents of the Bill may argue that, even if it were enacted, it would still not be possible to make GPs or private nursing home owners co-operate with the commissioner's investigations. That is not true. The commissioner has the same powers as a judge when it comes to obtaining evidence, papers and so on. I am certain that he would not hesitate to use those powers if he considered it necessary. However, they are useless if the individual involved is not within his jurisdiction in the first place. The key point is to get those ex-practitioners within his jurisdiction, as the Bill seeks to do.
I must also consider these issues from the perspective of accountability and trust. We take the accountability of GPs very seriously indeed. As my right hon. Friend the Secretary of State told hon. Members on 1 February, the relationship between individual doctor and individual patient is built on trust. For that relationship of trust to work, GPs must be accountable for what they do. My right hon. Friend was speaking in a very different context on a very sombre occasion, following the sentencing of a GP for a series of crimes which Mr. Justice Forbes, the judge presiding in the trial, described as a calculating and cold-blooded perversion of his medical skills.
The independent inquiry that we have announced, chaired by Lord Laming of Tewin, will examine all aspects of that case and make recommendations to protect patients in the future. The inquiry will consider all the circumstances and it would be wrong of me to pre-empt that by dwelling on the case today.
However, there are two reasons why I have referred to it. The first concerns loopholes. As the right hon. Member for Wealden explained, there is a perceived loophole in the wording of the 1996 Act. We are not afraid to close loopholes where that is necessary. In the case to which I referred, we found that the way in which the NHS tribunal works meant that the NHS would continue to pay a person convicted of most serious crimes for about another month following the conviction. That was inconceivable, and we took action immediately to make sure that it did not happen.
We also found that there was nothing to require a doctor to disclose to prospective partners or to a health authority a past criminal conviction or a previous professional censure. In the case to which I referred, the doctor had a past conviction for obtaining and misusing a controlled drug and he had a record with the General Medical Council, but in the past that appeared to count for nothing. That, too, must change. There was also no requirement for GPs to report deaths in their surgeries or other serious incidents to health authorities. That, too, needs to change.
The case also put the existing powers and processes of the General Medical Council under the spotlight. We have said that the GMC's involvement in that case will be examined by the inquiry, so that lessons are learned and recommendations for reform made. However, we are also acting quickly to give the GMC the powers that it says it needs. They include: interim suspension, to enable the GMC to take action in the public interest; a new committee to consider interim suspension, with much greater lay involvement; and an ability to strike off for

life except in the most exceptional circumstances. I repeat that we are not afraid to close loopholes when necessary in the interests of patients.
The second reason why I mention the case is the need for greater accountability of clinicians for the benefit of their patients. For a relationship built on trust to work as it should, it is important that patients can be assured that they can complain if they have a problem, that their complaint will be taken seriously and dealt with properly, and that if something has gone wrong, it will be put right.
The Government and the medical profession are taking action to modernise regulatory structures and to identify and deal with poor performance because of the need for better accountability of clinicians. That is why the GMC is developing proposals for assessment and revalidation at five-yearly intervals of all doctors' licences to practise. We are urging the GMC to keep up the momentum of developing those proposals.
To strengthen and underpin that work, the chief medical officer produced recommendations, which were published in November 1999, in his report "Supporting Doctors, Protecting Patients". His recommendations are comprehensive, and form part of a modernization programme designed to prevent, identify and deal with the small minority of doctors whose performance gives cause for concern, and to take quick action to remedy that. For example, the chief medical officer proposes that there should be an annual appraisal of all doctors. That is a key proposal.
Appraisal will cover all aspects of a doctor's performance, including compliance with contractual requirements. The chief medical officer proposes that health authorities should be able to suspend a GP when the circumstances suggest that patients may be at risk. Until now, health authorities have been unable to do that. He further proposes that GPs' participation in external clinical audit should in future be mandatory. At present, it is not.
Consultation on the chief medical officer's proposals finished at the end of February. The GMC's proposals for assessment and revalidation will need to tie in with them. We shall now consider the responses as a matter of urgency, but we shall press ahead as quickly as possible with measures that benefit and ensure the safety of patients.
The need for true accountability means that we shall also apply the system of clinical governance to all doctors. That will promote high standards of care and ensure accountability in a way that has not existed before. It will place quality at the heart of health care by ensuring access to effective, prompt, high-standard care whenever a patient is treated in the NHS. Clinical governance provides NHS organisations and individual doctors with a framework for quality improvement.
Too often, we hear of incidents that occur in the NHS that should have been avoidable if the lessons of past experience had been properly learned. That is why we asked the chief medical officer to convene an expert group to examine the mechanisms whereby the NHS currently analyses and learns from adverse health incidents, and to make recommendations for improvements.
The main components of clinical governance are clear lines of responsibility and accountability for the overall quality of clinical care; a comprehensive programme of quality improvement activities; clear policies aimed at


managing risk; and procedures through which all professional groups can identify and remedy poor performance. It is about a positive, demonstrable change of culture to one of learning, so that quality infuses all aspects of the NHS's work. Our aim is a coherent framework for clinical quality improvement, on the basis of best activity and practice, and with the highest standards.
All those steps, which will improve the accountability of doctors without preventing them from getting on with their job of treating and caring for their patients, are essential and will be established. They will provide assurance and reassurance for patients. We have a responsibility for that.
However, we also have a responsibility to ensure that we are scrupulously fair to the practitioners and providers who could be affected by the proposals in the Bill. The right hon. Member for Wealden expressed the hope that the measure would not be perceived as providing for a witch hunt.
One of the key elements of any complaints process must be that it is fair to all parties. The proposals in the Bill would potentially leave the practitioners and providers involved susceptible to investigation by the commissioner indefinitely. To me, that seems just as unfair to those individuals as the current system—as perceived by those who object to it—is unfair to complainants. Speaking as a lawyer, may I say that even the legal system recognises the unfairness of indefinite liability in civil cases, and sets limitation periods. I therefore believe that if the extension to the commissioner's jurisdiction were introduced, it should not be an indefinite power, but should be appropriately time limited. That would remove the permanent sword of Damocles that would hang over the heads of those individuals—most of whom, we must remember, will have been committed hard-working people with no reason to suppose that they might be complained about. It will also deal with the perceived risk that I mentioned earlier of less scrupulous practitioners retiring or resigning simply to avoid investigation.
However, determining an appropriate time limit is not easy. The commissioner has a time limit within which complaints must be submitted to him. It is generally not more than one year after the complainant becomes aware of the events being complained about. However, I appreciate that the commissioner has discretion to waive the time limit in special circumstances.

Mr. Dismore: I have concerns about the time limit, which I expressed in my speech. I am worried about the mismatch between complaints through the complaints procedure and possible legal action. If one of our aims in improving the ombudsman's service is to get rid of litigation, does my hon. Friend believe that there is a case for reconsidering time limits to try and achieve that objective?

Ms Stuart: We need to have a time limit that matches other procedures and does not add to confusion, but that streamlines the process. One option might be to apply a similar time limit to complaints about ex-practitioners: a year under potential discretion. However, there are issues

involving the way in which the commissioner should be expected to deal with cases in which he decides to exercise his discretion to waive his time limit, with the effect that the ex-practitioner will have been out of NHS practice for more than a year.
Another option might be to go for the three-year limitation period used in most cases by the civil justice system. That would be in line with practitioners' civil liabilities. Claims can still be brought against them after they have ceased NHS practice. That would also deal with circumstances in which the commissioner decides to apply his discretion to his own time limits.

Mr. Hammond: Can the Minister make it clear whether she is talking about a time limit for the initiation of the complaints process at its first level or for the commissioner's involvement? If the process at the lower tier had already started, would she allow it to continue without limit or is she saying that there should be no capability in any case to refer a retired person to the commissioner after a certain time had expired?

Ms Stuart: I am grateful for the opportunity to clarify that. The perceived loophole is that a practitioner is beyond the scope of existing measures if he is no longer in the NHS when a complaint is made. The issue is how long he has been out of the NHS and the time limit on pursuing him after he has left the service. If the Bill is to progress, we need to discuss an appropriate time limit, and the health service commissioner may have views on the most practical way forward. An open-ended time limit is unsatisfactory at this stage and I do not think that it would either help the commissioner or be fair to practitioners. We need to consider further what would be an appropriate time limit to take forward.

Mr. Alan Williams: In that case, will my hon. Friend consider the Government's tabling an amendment in Committee to deal with that problem and so perhaps make the Bill acceptable to them?

Ms Stuart: That is a useful way forward and I thank my right hon. Friend for his suggestion. If the Bill is to proceed, the Government would want to table an amendment. That would allow us the time to think things through in more detail and consult with the appropriate bodies.

Mr. McWalter: Does my hon. Friend not agree that the Bill would be a great improvement on current law even without such a change, and that we should consider it from that perspective?

Ms Stuart: I do. The Bill is a way forward and would be an improvement.
May I share some of the Government's concerns? A practitioner may still get off the hook if the time limit is brief, but we have to reach a compromise between what is fair and what is workable for all parties concerned. We must also remember, of course, that the commissioner does not have indefinite powers to investigate. The amendment that the Bill offers would not change that in any way.
Perhaps the worst aspect of the current situation is that there have been cases of the commissioner beginning an investigation only to have to discontinue it because the


practitioner resigns or retires. For example, in a case involving one GP, the statement of complaint was issued, but the commissioner was informed that the GP was due to retire in two months. As there was no way that a proper investigation could be carried out in that time, he had no choice but to decide not to pursue the case.
It must be absolutely heartbreaking for complainants in such cases—who have been led to believe, in good faith, that their concerns will be properly considered—to be told that that will not happen after all. It must also be incredibly difficult for the ombudsman to have raised a complainant's expectations only to have to disappoint him. The right hon. Member for Wealden eloquently explained Mrs. Fisher's case, which is a good example of the current problem. Tabling an amendment that set a time limit would still allow such cases to be caught, and, in the example that I gave, the commissioner would have been able to continue his investigation, irrespective of the GP's retirement.
The right hon. Gentleman and other speakers mentioned the review of the organisation of public sector ombudsmen that is under way in the Cabinet Office. We should all be fully aware of the review as we were invited last year to participate, via a survey of all Members of the House. Nevertheless, I want to say a few words about how the initiative is progressing.
The review was set up by the Government in March 1999 in response to proposals made by the Commission for Local Administration, the parliamentary commissioner and the health service commissioner. Against the background of more integrated services, which the Government have been working hard to develop, the ombudsmen felt strongly that the time was right for a wide-ranging review of the way in which they conducted their respective business and suggested the creation of a single body. That would do away with potential conflicts of jurisdiction, which they believe are intrinsic to their current structures.
The review's terms of reference did not point the review team down particular avenue. Value for money and the best interests of complainants featured as key issues to be taken into consideration. In reaching its conclusions and formulating its report and recommendations, the team consulted widely among the representative and professional bodies, central Government Departments, local government departments, members of the public and academics, and I understand

that the Consumers Association submitted evidence. The team also canvassed the views of all Members of the House.
However, the review raises the issue of how useful the timing of the Bill may or may not be. Irrespective of the detail of the report's recommendations, the very nature of the review, and the terms of reference it was given, makes it more or less inevitable that the jurisdictions of all the public sector ombudsmen, including the health service commissioner, will need to be scrutinised very carefully. That process must be comprehensive and thorough. The aim must be to ensure that we have mechanisms that are modern and dependable. They must live up to the expectations of the general public who will be using them, and must be fit for the 21st century.
I shall not pretend to the House that this change can be made quickly. Indeed, I firmly believe that it would be a grave mistake to try make it quickly, because the matter is too important to rush. However, it is also important to close the loophole identified by the Bill. There is an argument that, in the context of this major review of the ombudsmen, now is not the time to be making changes to his jurisdiction. That is a fair point. We know, however, that the current wording of the 1993 Act is already causing problems for the commissioner, and it is right that, having been given an opportunity to resolve this difficulty via this Bill, we should do so.
At its heart, the Bill is about professional accountability. As I have explained, we take that extremely seriously, and are taking action on a number of fronts to support and strengthen GP accountability in particular. The Bill offers another way of doing that, and it would be perverse for the Government not to support any proposal that achieves that aim. The right hon. Member for Wealden may like to know that officials of the National Assembly for Wales are content with these proposals.
12.7 pm

Sir Geoffrey Johnson Smith: With the leave of the House, I should like to thank the Minister for the commitment that she has just made—subject of course to our looking favourably on the time limit that I understand she is to suggest. I would certainly be willing to consider that, in the hope that we could gain the overall support of the Committee. I am grateful to her for that offer.

Question put and agreed to.

Read a Second time, and committed to a Standing Committee, pursuant to Standing Order No. 63 (Committal of Bills).

Orders of the Day — Food Labelling Bill

Order for Second Reading read.

Mr. Stephen O'Brien: I beg to move, That the Bill be now read a Second time.
In presenting the Bill, I shall describe how and why I came to select the issue of honesty in food labelling, explain the scheme and the contents of the Bill, and emphasise the opportunity that the House and the Government have to enable vital legislative progress to be made, which this issue deserves and which the people of this country, both consumers and producers, demand.
As the House knows, I had the honour and privilege to be elected only seven months ago to represent the constituents and interests of Eddisbury. My constituency covers south-west Cheshire. I took my seat on the day before the House rose for the summer recess, so I had, in effect, only been in the House and seen the way in which it works for a few weeks when I came 10th in the private Member's Bill ballot—not only to my surprise, but to the surprise and, in some instances, consternation of right hon. and hon. Members. Comments such as, "He's only been here a few minutes" were at the generous end of the wide spectrum of remarks that flooded my way when the result of the ballot was announced.
In common with other right hon. and hon. Members who gained places in the high and middle orders of the ballot, I was immediately confronted with a truly staggering quantity of mail that poured in from individuals and organisations, all urging me to adopt their suggestions for a Bill. It amounted to a menu of scores of worthy and, occasionally, wacky causes.
To understand why I stuck with my first instinct to introduce a Bill that would provide for simple, clear and, above all, honest labelling of foods in this country—for reasons that will become apparent, the Bill is designed to encompass England and Wales; I shall refer to the position in Scotland and Northern Ireland later—it is helpful to rewind the clock a little to the by-election that brought me to the House in the first place.
Being elected in a hard fought by-election in a marginal seat is an invigorating and exacting experience, as other right hon. and hon. Members who have won their seats in similar circumstances will testify. The great benefit of the experience is that, during by-elections, issues of key relevance to local electors—in Eddisbury, in my case—are played out in the relentless glare of publicity on the national stage, and in the intense atmosphere generated by a three-week campaign.
At the point where the west midlands end and the north-west starts, Eddisbury's profile—its main town of Winsford, containing 27,000 people, its northern villages and its rural communities, covering by far the greater part of the constituency geographically and bordering Wales and Shropshire—is typical of the country as a whole. Its opinions therefore constitute a fair weathervane of the issues that confront all the people of the country. It was all too painfully clear during the by-election campaign that farmers in south-west Cheshire and throughout the country were experiencing desperate times. As has been acknowledged by Members in all parts of the House, their plight has only worsened in the months since then, but those who have survived continue to deliver products of the highest quality, despite mounting losses.
At a time when the public are ever more conscious of, and concerned about, the British farming crisis, more and more consumers want to support farmers by buying British whenever and wherever they can—not only on the basis of quality and value for money but, perhaps crucially, because of their recognition that our farmers are producing food to the highest standards of production, and, in the case of livestock, because of the exemplary animal welfare practices insisted on, and robustly policed, by the United Kingdom. In many instances, however, our farmers and producers face intensely unfair competition from importers of foodstuffs in countries whose inferior standards of production and welfare mean that their production costs are considerably lower.

Sir Nicholas Lyell: Every word that my hon. Friend has said about hard-pressed farmers, especially pig producers, applies to the many pig producers whom I represent. I hope that we shall find a way of giving his Bill a fair wind.

Mr. O'Brien: I thank my right hon. and learned Friend. I believe that the issues raised in my Bill affect constituents and farming communities up and down the land, and that the Bill has a general application. It was clear to me that the feeling in Eddisbury typified the mood in much of the country, and I hope that we can make progress with the Bill so that we can help farmers and consumers.
We should consider the interests of farmers in conjunction with the powerful mistrust and lack of confidence that has developed among consumers in recent years. Food labelling has been shown to be misleading. There have been well-publicised instances of products that appear from the label to be British, but in fact come from outside the country. There is an overwhelming need to secure simple, clear, honest labelling. The Bill's purpose is to ensure that labels and marks relating to the country of origin and the standards of production of food presented for sale enable consumers to make an informed decision about which food they want to purchase.

Mr. Tim Collins: Does my hon. Friend agree with me, and with farmers throughout south Cumbria, that perhaps the most scandalous example of the misrepresentation to which he refers is the application of a Union jack to products that have merely been packaged in this country, and did not originate here? Would his Bill not help to correct that damaging misrepresentation?

Mr. O'Brien: As my hon. Friend knows, I share his deep affection for south Cumbria, and any measure that helps farmers there—and, of course, those in south-west Cheshire—has my full support. My hon. Friend may well find that the example he has given is referred to a few paragraphs later in my speech.
The Bill meets the demands of my constituents and the needs of consumers and food producers throughout the country. Therefore, my decision to introduce it, in effect, made itself. It was for me a simple, clear and honest choice. The cause is not only worthy, but is a real opportunity to be effective in tackling an issue of the utmost seriousness to the people of this country, whom we all represent in this House.
Although the crisis in the farming industry was a key factor in my decision to introduce the Bill, it is intended not to be, nor to form part of, a nationalistic, anti-competitive buy-British campaign, but rather to give the force of law to simple, clear and honest food labelling, so that consumers have the facts that they need to enable them to make an informed choice. If that information results in consumers choosing to buy British-originated and produced food, for whatever reasons, all well and good.
Since announcing my decision, I have been genuinely taken aback at the scale and warmth of support that I have received for the Bill. It carries the hopes of farmers, producers and consumers up and down the land. That support starts in the House, and I am grateful for the cross-party support that I have received in launching it. It is truly an all-party measure. If it reaches the statute book, it will be a credit to the House and, I believe sincerely, to the Government—who will, I fervently hope, even at this eleventh hour support it and allow it to make progress.

Mr. Oliver Letwin: Has my hon. Friend had any communication from the Ministry of Agriculture, Fisheries and Food about the Bill? Might one not have expected that he would immediately have been called in, congratulated and helped? Has he encountered that attitude?

Mr. O'Brien: I am grateful to my hon. Friend for that intervention. As it happens, I did not receive such an invitation. There has been some contact between the National Farmers Union and MAFF in relation to the Bill. I have had the benefit of being briefed on that contact, but at a personal level the answer is no.
I pay tribute to the sponsors of the Bill, who traverse the political spectrum. As well as the support of my hon. Friends the Members for Hexham (Mr. Atkinson), for Mid-Dorset and North Poole (Mr. Fraser), for North Wiltshire (Mr. Gray)—who I see is in his place—for South Holland and The Deepings (Mr. Hayes), for Epping Forest (Mrs. Laing), for North Shropshire (Mr. Paterson)—who represents my neighbouring constituency and with whom I share the largest milk field in Europe—for North Norfolk (Mr. Prior) and for Uxbridge (Mr. Randall), I have the support of Members from the Government Benches: the hon. Members for Glasgow, Pollok (Mr. Davidson) and for Heywood and Middleton (Mr. Dobbin). I am delighted to have the support, too, of the Liberal Democrats in the form of the hon. Member for Hazel Grove (Mr. Stunell), who I am pleased to see in his place.
Amplifying the support for the Bill, I refer the House to early-day motion 445, which is in my name, that of my hon. Friend the Member for South Suffolk (Mr. Yeo), the shadow Minister of Agriculture, Fisheries and Food—I am most grateful to see him here—his shadow agricultural team colleague, my hon. Friend the Member for South-East Cambridgeshire (Mr. Paice), and, as of this morning, 60 other right hon. and hon. Members from the Conservative, Liberal Democrat, Ulster Unionist and, let me emphasise, Labour Benches.
The early-day motion states:
That this House, noting the Prime Minister's statement in his speech to the National Farmers' Union of Tuesday 1st February, in which he promised to introduce new labelling guidance to make sure foreign goods are not passed off as British simply because they have been processed in Britain, calls on the Prime Minister and Her Majesty's Government to support and give speedy passage to the Food Labelling Bill introduced by the honourable Member for Eddisbury which would put the full force of the law behind clear, simple and honest labelling, address those very concerns on labelling raised in the Prime Minister's speech and provide for a fair deal on labelling for both consumers and farmers.

Mr. Paul Tyler: I, too, wish to express strong support for the Bill. I hope that there will be rapid progress today, not least because it might give an opportunity for my Bill later. In relation to simple, straightforward and non-confusing labelling, may I draw the hon. Gentleman's attention to the importance of organic food? A huge proportion of organic food in this country is imported: three quarters, approximately. The consumer is not aware of that, but it is relevant to his Bill. I hope that, together, we can make progress in both directions.

Mr. O'Brien: I am grateful to the hon. Gentleman. Although many points need to be made on the issue, I shall try to keep my remarks to their absolute minimum. However, I hope that with the full consensus on the issue that I fervently hope will emerge in this debate, his Bill will soon be considered. If we can establish the principles to ensure simple, clear, honest and not misleading labelling, by passing my Bill the hon. Gentleman's concerns on organic foods—and concerns on various issues on which I have received correspondence from all sorts of interested groups—may be dealt with more effectively. However, addressing all those issues will require a much wider and more detailed debate.
Early-day motion 445 asked the House to implement the Prime Minister's promise. I tabled it on Tuesday. On Wednesday, however, the Government tabled a negative amendment to block my early-day motion. It was signed only by Labour Members. I am not sure whether Whips' narcs is an unparliamentary expression—I see that my own Whip nearly took the words out of my mouth—so I shall not use it
Nevertheless, intriguingly and surprisingly, on the same day—Wednesday—as signing that negative, anti-British-consumer, anti-British-farmer amendment, the hon. Member for Huddersfield (Mr. Sheerman)—who is Chairman of the Education and Employment Committee, of which I am privileged to be a member—signed the all-party early-day motion 209. That early-day motion was signed also by the hon. Members for Amber Valley (Judy Mallaber) and for Erewash (Liz Blackman), both of whom also signed the negative amendment to my early-day motion.
Early-day motion 209, on stall and tether-produced pigmeat, states:
That this House is deeply concerned about the import of cheap pigmeat from countries which use sow stalls and tethers, systems which have been illegal in the United Kingdom on cruelty grounds since 1st January, following the agreement of the House in 1991; believes that these imports are undermining the United Kingdom pig industry; condemns those supermarkets, caterers and public procurement agencies which are continuing to sell or use imported pigmeat derived from foreign herds which use sow stalls and tethers; believes that United Kingdom stall and tether-free pigmeat should have a marketing premium over imported pigmeat produced using


sow stalls and tethers; believes that the marketing premium is dissipated in the absence of mandatory labelling as to production method; believes that consumers are being misled by the absence of mandatory labelling of production method on pigmeat products; calls on United Kingdom supermarkets, caterers and public procurement agencies to support the United Kingdom's newly-raised sow welfare standards by selling or using only stall and tether-free pigmeat; and calls on Her Majesty's Government to introduce legislation similar to that recently enacted in Switzerland requiring meat produced by methods which would be illegal in the United Kingdom to be labelled as such.]
The final words of the motion specifically state that the House
believes that consumers are being misled by the absence of mandatory labelling of production method on pigmeat products; and calls on Her Majesty's Government to introduce legislation similar to that recently enacted in Switzerland—
which is outside the European Union, of course—
requiring meat produced by methods which would be illegal in the United Kingdom to be labelled as such.
Even more intriguingly, the hon. Member for Kettering (Mr. Sawford) not only was one of the first six signatories to Wednesday's negative amendment to my early-day motion 445, but, on the same day, signed the all-party early-day motion 62. Only yesterday, the hon. Member for Sunderland, North (Mr. Etherington)—who was an early signatory to early-day motion 62—signed the negative amendment to early-day motion 445. Early-day motion 62 calls for mandatory country of origin labelling across the European Union. Oh dear, what a tangled web those Whips weave.

Mr. Letwin: Does my hon. Friend agree that there is another hon. Member about whom we need to know more? In the House, the Agriculture Minister said:
I want to clamp down on misleading place of origin descriptions.—[Official Report, 28 October 1999; Vol. 336, c. 1126.]
Was he perhaps a signatory to my hon. Friend's early-day motion?

Mr. O'Brien: My hon. Friend, as usual, makes such a very good and insightful point. However, I did not spot the Minister's name on my early-day motion. As for the Minister's use of the phrase "clamp down", my hon. Friend will have to wait for my mid-term peroration on this part of my speech to hear how that has been handled.

Mr. Tony McWalter: Does the hon. Gentleman agree that it is not usual for Ministers to sign early-day motions? His negative remarks on that point should, therefore, not be misconstrued. I also hope that the hon. Gentleman will not go too far down that road, as there are clearly some defects—which I am sure we shall tease out—in his rejected Bill. Nevertheless, I am sure that many people support his objectives and want them to be realised. The more constructive he is, the more likely he is to achieve his aims.

Mr. O'Brien: I thank the hon. Gentleman for that intervention, and of course I wish to be constructive. However, I have to paint in the background against which I am introducing my Bill. Although I appreciate that we belong to different parties, and that different Back Benchers will hold different views, I am trying to

understand the mixed messages that have come from the Government on the issue—for which they are responsible and accountable.

Mr. Kelvin Hopkins: Will the hon. Gentleman give way?

Mr. O'Brien: Let me finish this point first.
In trying to understand the background to the Government's thinking in the context of introducing the Bill, it seemed to me that, in their rush to get Labour Members to put their names to the negative amendment on Wednesday, the Labour Whips have caused mayhem, muddled thinking and great embarrassment to some of their own Back Benchers. This may be a sign of confusion or panic or both. It is certainly a great disappointment to their constituents.

Mr. Andrew Dismore: I am grateful to the hon. Gentleman for giving way. I was certainly not confused when I signed the amendment to his early-day motion and I hope to explain my views later in the debate.

Mr. O'Brien: As ever, I look forward to the hon. Gentleman's brief contribution to the debate. He is completely exonerated from the charge of signing three completely contradictory early-day motions. That was the point that I was elucidating earlier. I promised to give way to the hon. Member for Luton, North (Mr. Hopkins).

Mr. Hopkins: A few moments ago, the hon. Gentleman glossed over the significant difference between pursuing legitimate changes in EU legislation—with which I would agree—and pursuing changes in national legislation that would not be acceptable within the EU framework. There is a crucial difference which I hope to address in more detail later in the debate.

Mr. O'Brien: I shall address those issues in some detail. Of course they have been disclosed to some degree in the amendment to early-day motion 445. I was aware of them previously, and I have conducted some fairly detailed research. I hope that I will be able to demonstrate that there are other arguments that suggest that the Bill may not face the insurmountable obstacles that the Government think it will face vis-à-vis the EU.
Against that extraordinary and somewhat baffling background, I am pleased to introduce the Bill today. More positively, I am pleased that it has been welcomed by the National Farmers Union, the National Pig Association and the Consumers Association. I should like to express my appreciation and gratitude to the NFU and the NPA for the extensive time, expertise, encouragement and assistance that they have given me in drafting and publicising the Bill.
On Monday, I was presented with a petition in support of honesty in food labelling with more than 3,000 signatures from people from the north-west of England. Hon. Members on both sides of the House represent people in the north-west. The petition forms part of a larger petition of more than 52,000 signatures collected by the NFU and others up and down the country in support of the Bill and the principles contained within it.
There is a widespread feeling that the current position on food labelling is simply not adequate and that the necessary improvements to the labelling of food in Britain


need the full force of the law behind them. That point was supported by the Consumers Association on behalf of the consumers of this country who have said that, in empowering consumers, the Bill is a step in the right direction.
As I have said, the Bill seeks to ensure that consumers are properly informed about the country of origin and the standards of production of food that is presented for sale. I believe that the Bill can achieve those aims by putting the full force of the law behind honest labelling.
Under the current food labelling regulations, a pork pie labelled "Produced in England" could have been made with Belgian or Brazilian pork. The consumer is unaware of the origin of the ingredients or how the product was made. The justification for the Bill can be summarised in the following words:
We produce some of the best food in the world to exacting quality, hygiene and animal welfare standards. Our industry should get the credit and the premium for it. Consumers need to know when they buy food labelled as British, it is British food produced in Britain.
Those were the words of the Prime Minister in his speech last month to the NFU. In the same speech he announced that new guidance would be issued on country of origin marking,
so that the consumer can choose, not be misled, and the farmer gain credit for local-sourced produce and British quality standards.
I agree with those aspirations, but I also believe that consumers can never have 100 per cent. trust in food labelling unless they know that the full force of the law stands behind them, defending their interests.

Mr. McWalter: Does not the hon. Gentleman agree that the advice given by MAFF to trading standards officers on 1 February this year would specifically rule out the idea that somebody could label a pork pie "Produce of Britain" or "Produce of England" if the pork was actually Belgian? The current trading standards regulations would mean that the pork pie would have to be labelled "Belgian pork, finished in Britain" or words to that effect. I am not sure that the hon. Gentleman is right in his portrayal of the current situation.

Mr. O'Brien: I am grateful for that detailed intervention and I shall deal with those points later. The hon. Gentleman is right to raise the issue of the operation of the trading standards officers. I do not know whether it is true that the 1 February guidelines, which were an attempt to toughen up the position, will rule out such labelling, and that point goes to the heart of whether we need a statute that gives the force of law. It could be argued that the guidelines are an exhortation—

Mr. Letwin: Does my hon. Friend agree that if the Bill falls foul of European law, that must also apply to the guidelines if they have any real effect?

Mr. O'Brien: As ever, my hon. Friend makes a forensic point. The guidelines would be in contravention of European law only if they had the force of law. If they do not, there is nothing to which the European Union could object because they are only advice. We will want to hear a little more from the Government on that point.
The full force of the law needs to be behind consumers' interests. One of the reasons why the public demand for better food labelling has grown recently is the high profile

food safety scares, such as the Belgian food scare and the revelations about French farming practices. Those scares have challenged the public faith in food labelling and mere guidelines are not enough to allay those fears.
The Government response will, I believe, be that the labelling guidelines issued on 1 February have the force of law. Let us be clear about those guidelines. They have been issued to trading standards officers to indicate how the Government expect them to discharge their duties with regard to misleading food labels. The guidelines facilitate only the prosecution in court by trading standards officers of, for instance, pork producers who import Dutch pork packed in the UK and sell it as British. In truth, those producers do not just label the pork as British, they label it "Produced in Britain", which is not necessarily caught by the current regulations, as the hon. Member for Hemel Hempstead (Mr. McWalter) sought to establish.
If the argument that the current regulations are sufficient is advanced by the Government, I do not believe that it will hold water. The preamble to the guidelines is, unlike today's food labels, simple, clear and honest. It states specifically that the guidance is "informal, non-statutory" and that the notes should not be taken as an authoritative statement or interpretation of the law, because, as it continues
only the courts have this power.
Therefore, the guidelines are not even a statutory code like the "Highway Code".

The Minister of State, Ministry of Agriculture, Fisheries and Food (Ms Joyce Quin): Perhaps I should make it clear to the hon. Gentleman, because he does not seem to understand the point, that the guidelines interpret the law that the previous Government passed while putting into effect a European directive that the previous Government also passed. It is the terms of that directive, to which the previous Government agreed, that make the Bill's proposals contrary to European Union law.

Mr. O'Brien: I listened carefully to the Minister, and I acknowledge that the previous Government introduced the food labelling regulations and implemented the EU directive. The Minister is right that the guidance notes do not have statutory force, but are intended to give guidance towards legal enforcement. However, nothing has changed since 1 February except that the guidance has been reissued. We know that the law that existed before did not address the problem, with the result that the deep unease about labels that might be misleading has persisted since 1996.
The 1 February guidelines may lead to some improvement, although we may have to wait a little longer to be sure. However, the nature of the law has not changed. The same legal base for enforcement remains in place; only the guidelines have changed. I therefore believe that my point is valid, despite what the Minister said.

Sir Nicholas Lyell: The Minister will know that the guidelines may help trading standards officers enforce the law in cases of misleading labelling, but they do not have the force of law.
Does my hon. Friend agree that the Ministry may have been given defective advice? Clause 3 deals with welfare standards and does not ban EU produce in the way that


the French banned British beef. For example, EU pigmeat can come into this country freely. Does my hon. Friend accept that the Bill merely seeks to make it clear to consumers that food complies with the higher animal welfare standards required of British farmers?

Mr. O'Brien: I thank my right hon. and learned Friend, although I hesitate even to confirm the legal case that he presented with such erudition. However, it is absolutely right to emphasise that a precedent was set when the British acceded to the French demand that British beef be labelled as such in France. That matter is being considered by the European Court of Justice, but we believe that it is contrary to EU law because it amounts to a ban on importation. My right hon. and learned Friend has pointed out that clause 3 would not impose any form of ban on imports; it merely requires that information be made available that would allow a comparative reference to be made. That would give consumers the ability to make an informed choice, something for which they have been crying out.

Mr. Letwin: Does my hon. Friend agree that we have witnessed something extraordinary? He has just received advice, in Parliament, from a former Attorney-General, yet the Ministry of Agriculture, Fisheries and Food has not made the slightest move to determine whether its legal advice on the matter is right or wrong.

Mr. O'Brien: I defer to my hon. Friend's longer experience in the House. I have been here such a short time that I did not know what to expect in terms of the procedure involved in introducing the Bill. It did occur to me that the Ministry might want to be in touch with me to find out whether there was common ground between us. I published the Bill at the proper time, and although I was slightly disappointed that no contact was forthcoming, I assumed that that was normal.
It might have been very helpful to discuss the Bill with the Ministry. I do not know of any hon. Member who questions the principles behind the Bill, and it is disappointing that the debate has centred on technicalities. I shall turn to the details later, but earlier contact with the Ministry would have ensured that the opportunity represented by the Bill would not be missed, as it would have allowed us to hear learned advice of the sort given by my right hon. and learned Friend the Member for North-East Bedfordshire (Sir N. Lyell).
The guidelines do not even amount to a statutory code in the same way that the "Highway Code" does. The Government say that they expect trading standards officers to operate using the guidance but that is not the same as saying that they must. The exchanges and interventions that have taken place have underscored that point. In her response, will the Minister give a simple, clear and honest answer to a simple, clear and honest question: how many prosecutions have there been for misleading labels on country of origin?
What consumers are asking about foods, here and in other countries, is where does it come from and how is it made? The voluntary undertaking by the British Retail Consortium in November 1998 and the regulations have made progress, but not enough. Otherwise, consumer mistrust of misleading labelling would not be persisting and growing. The force of law is needed—hence my Bill.
The Bill builds on, rather than detracts from, the current position on food labelling. Hon. Members will note that its long title states that it makes further provision for consumers of food to be informed about the country of origin and standards of production of food presented for sale by labelling, marking or in other ways. That takes into account the recent introduction of the Food Standards Act 1999, which established the Food Standards Agency. The Minister will recall that the Government later inserted an amendment in another place after strong prompting, it has to be said, from my shadow agriculture team colleague, Baroness Byford. That amendment made it clear that in the context of what is now the 1999 Act, the interests of consumers include the labelling of foods. The reference to being informed is a direct lift from the phrase "informed" decisions from the Food Standards Act.
Clause 1 contains the definitions to which I shall refer back when the terms appear in context, save that I highlight the fact that the Bill has been drafted to sit on all fours with the existing food labelling regulations of 1996. It incorporates by reference many of the terms used in those regulations, given the thinking and experience that lie behind those existing non-statutory provisions—which do not have the force of law—a statutory basis.
Clause 2 provides a requirement for food to be marked or labelled at the point of sale to a consumer—the purchaser, rather than the person who consumes all the food—with the particulars of the country of origin. In the case of a single-ingredient food, such as a joint of beef—preferably on the bone—or an orange, that would be simple enough. However, clause 2(1)(a) also provides for the possibility of more than one country of origin, requiring all countries of origin to be identified. For instance, a single-ingredient product such as lettuce may be sourced from different countries. In its pre-packed form, mixed-leaf lettuce may be sourced from different lettuces from different countries but is presented for sale as one food item. The label would simply have to state all the countries of origin, even where, in a pre-pack, the single item—each individual lettuce leaf—could not necessarily be identified as having come from one or other of the countries of origin. The label might read that the countries of origin were countries A, B and C.
That is what the consumer needs. If for any reason, he or she prefers products from a certain country, the necessary information would be available for him or her to make such an informed decision. If the consumer wants to buy a product, such as beef, from one particular source country, the information would be there. As for my second example of lettuce, in exercising that choice, the consumer may want to purchase lettuce from elsewhere, from a supplier who can be sure, as evidenced by the labelling, which can be legally relied upon, that the lettuce comes from, say, the Channel islands—any why not?
Clause 2(1)(b) makes provision for food products containing more than one ingredient. It would be impracticable and an unjustified burden to provide the consumer with the information with which he or she can make an informed choice, by labelling the country of origin of every ingredient, such as seasoning and other additives. In any event, those matters are well covered and are available as information on labels under the present regulations requiring identification of ingredients. Therefore, the Bill would require only that the identity of the country or countries of origin of each major ingredient is on the label.
For the purposes of the Bill, I have defined a major ingredient, as set out in clause 1, as one that forms more than 25 per cent. by weight of a food product. That is straightforward. The weight of constituent ingredients of a food product is already generally a requirement under the existing food labelling regulations and a food producer will have the information when the ingredients are sourced. The more than 25 per cent. by weight threshold is a proposal that balances the need for relevant information—that is information that tends to affect consumer preferences—against introducing an over-burdensome or irrelevant set of requirements.
I freely accept that the threshold may be an issue that Members wish to debate further. I look forward to that opportunity today and, I hope, in Committee where we can consider the issue in greater detail. In the case of a pre-cooked and packaged shepherd's pie, the country or countries of origin of both the meat content and the potato content would need to be identified. In the case of pork sausages, the country or countries of origin of the meat content would have to be identified, but not the origin of the seasoning.
Clause 2(2) goes to the heart of one of the most crucial matters in the Bill. It addresses an issue of the greatest concern to producers and consumers that has led to mistrust and lack of confidence in labels. When a food has been packaged and processed in a country other than the country of origin, under my Bill, the country of origin would be shown at least as prominently as the particulars of the country where the food has been processed or packaged.
Let us consider the example of chickens bred in Thailand. They are stuffed with hormones that are illegal here and across the European Union. However, they are imported into this country or another EU state and processed and packaged in that member state, and they appear on our supermarket shelves with a label identifying them as being produced in the EU or even in a named member state. As my hon. Friend the Member for Westmorland and Lonsdale (Mr. Collins) pointed out, if they are packaged and produced in this country, the package may even carry a Union jack on them. No wonder shoppers feel anxious and are mistrustful of labels when they learn the truth from stories, such as the Thai chicken scandal, that naturally receive wide coverage in the media.
I am sure that you, Mr. Deputy Speaker, do not wish to consume food which you find, despite today's misleading but wholly legal labelling, is sourced from a country where the animal welfare, health and hygiene standards fall far below the standards we impose on farmers in this country.
In the opening speech in the debate in which I made my maiden speech, the Minister of Agriculture, Fisheries and Food stated his position on this issue:
I want to give clear, unambiguous information on the real place of origin, not place of processing or place of slicing; I want to clamp down on misleading place of origin descriptions; and I want to make further progress by lobbying the European Commission and other member states for a system of clear country of origin labelling.—[Official Report, 28 October 1999; Vol. 336, c. 1126.]

Sir Nicholas Lyell: I have been noticing with great pleasure that the Minister has been nodding assent to my hon. Friend's recent remarks in his carefully worded speech. Does he agree that it is important that the

Government allow the Bill to proceed to Committee and that that should not be put off by arguments that it might be challenged on the ground that it would constitute measures equivalent to quantitative restrictions on imports? That is far from clear and there is every reason to think that the Bill could be put into a form that would comply with EU law, even if it does not already.

Mr. O'Brien: I thank my right hon. and learned Friend. It is my fervent hope, on behalf of the consumers and producers of this country, that the Bill will be allowed into Committee. I do not hide the fact that I am a single Member of Parliament and brand new to this place and, among everything else that goes on, it has been hard work to get the Bill to this point. I would welcome the chance to have it considered in Committee, where there are more resources at the disposal of the parliamentary process, to hone it and to focus on the important issues, such as those raised by my right hon. and learned Friend. I hope that the Government will see fit, at this eleventh hour, to nod assent and, subject to the will of the House, allow the Bill to go to Committee.

Mr. McWalter: Is the hon. Gentleman confirming that if the Bill can be made European compliant by a series of steps, he will take those steps to amend it in Committee, in so far as he can, so that when it returns to the House, the European objection cannot be made against it?

Mr. O'Brien: It is incumbent on us to seek to make any law passed by the House European compliant. My point is that the proposals are not necessarily in contravention of European law, although they bear examination. However, we should not lose sight of the principles that we are trying to establish of simple, clear and honest labelling of country of origin and production standards. The latter point raises the compliance issues, and I shall deal with that in more detail.
In addition to what the Minister of Agriculture said on 28 October last year, when he used the phrase "clamp down", on 1 February this year he said:
I am determined to stamp out misleading labelling.
How does a Minister clamp down on or stamp out something other than by the force of law? The Bill would fulfil those commitments, by ensuring compliance through legislation rather than relying on voluntary guidelines, codes of practice or mere regulations.

Mr. Letwin: I saw the Minister shake her head earlier. As my hon. Friend has had the chance to talk to my right hon. and learned Friend the Member for North-East Bedfordshire (Sir N. Lyell), the former Attorney-General, does he agree that if the Minister of Agriculture intended to clamp down on and stamp out those practices and he sought to achieve that by guidance, he would be presumptively doing whatever the Bill is trying to do effectively, and if the Bill is in contravention of European law, the Minister's actions are so too?

Mr. O'Brien: As ever, my hon. Friend makes a forensic intervention, and I believe that I understood it and that it contains a serious point. [Interruption.] I would expect Labour Members to laugh a little, out of embarrassment. However, my hon. Friend has made a valid comparison.
The law exists to be properly argued both by precedent and by measure against statute or code. I am a former practising lawyer, although nobody would want to take advice from me because I have not engaged in the law for the past 10 years. I do not want to make a cheap point, but there is a cultural difference between the legal approach and thinking of this country, with its law of precedent culture, and those of continental Europe, with its Roman codification law.
We negotiate and arrive at a concluded position in law, to which we then hold. I know from many years of business experience in all countries of Europe that European legal culture consists also of negotiating and arriving at a concluded agreement, but as circumstances change and things go wrong, that agreement becomes, in effect, a statement of what was agreed on the day, but everything is still negotiable. My hon. Friend's point, which I have developed, is therefore important and ought to be given the serious consideration that it deserves.
The second limb of the Bill provides for the labelling of production standards for the food's raw materials. Countless surveys and much market testing reveal that after the BSE crisis and the more recent Belgian food scare, and following the strenuous efforts by producers, retailers and UK Governments of both colours, British consumers believe, rightly, that their benchmark today is the production standards that are required and applied in this country. However, well-publicised stories of misleading food labelling mean that consumers cannot be sure that the food that they buy is not from a country with inferior production, hygiene and animal welfare standards and that has led to a collapse in the public's faith and trust in food labelling. Clause 3 therefore provides that information be given to consumers by ensuring that, when a food's country of origin label under clause 2 discloses that it is sourced in a country where food production standards are
different from, and less demanding than, the production standards applicable in England and Wales,
the label or mark is required to state that fact.
Clause 1 defines production standards as
the minimum legal requirements relating to husbandry which must be observed by food producers, including requirements relating to animal welfare, food safety and environmental protection.
I do not pretend that it has been easy to come up with a workable definition of production standards such that international differences in standards can be measured. I believe that that has been achieved, but there might be scope to tighten the definition in the Bill, and I should welcome assistance from the Government and other hon. Members in ensuring that the clause avoids any vagueness in a legal sense. Again, that is a matter to be considered in Committee. Clause 3(2) provides that in deciding
whether, in relation to any food derived from livestock, the production standards in another country are less demanding than those applicable in England and Wales,
reference should be made to the standards applicable in England and Wales, namely
codes of recommendations for the welfare of livestock
which are, from time to time, issued under the Agriculture (Miscellaneous Provisions) Act 1968 and which remain in force.
As has been mentioned, that clause causes concern in the Government and other circles that the Bill might be incompatible with relevant single market rules. I do not believe that the obstacles are insurmountable. Food labelling is undeniably an area of EU competence and national Governments are not free to impose requirements that could be restrictive within the single market. I am aware that the Government are nervous at the prospect of Her Majesty's Government being prosecuted in the European Court of Justice if the Bill becomes law. I can well comprehend that that would be embarrassing, given that France now faces court action—albeit protracted, while our farmers continue to suffer unjustifiably from French action—for flagrantly contravening EU law by banning British beef unilaterally. However, those fears are less than well founded. Even if there were a possibility that the Bill is incompatible with EU law, that clearly has no procedural bearing on the ability of the national Westminster Parliament to enact the legislation.
I was genuinely disappointed and appalled to hear the response of the Minister of Agriculture to a question asked by the hon. Member for Hemel Hempstead. On being asked whether he agreed
that the best aid that the pig industry could receive would be to have a proper system of labelling,
he replied:
The legislation introduced through the private Member's route—
that is, my Bill—
is clearly designed to skirmish with the European Union, whose competence labelling is, rather than to solve any problem that is faced in the United Kingdom.—[Official Report, 10 February 2000; Vol. 344, c. 389-90.]
That was an unworthy, wholly cynical and improper answer. I can assure the House and the Minister, who is not present but whose right hon. Friend the Minister of State is, that thoughts of skirmishing with the EU have played no part in my thinking, or to my knowledge that of anyone else who has been involved with the Bill. On the contrary, I have taken great pains to avoid any clash with the EU. Lord knows, this country plays by the rules, often to its cost—certainly, to the desperate cost of our pig farmers.
It is fair to say that the Government have acted in response to Conservative and, at times, Liberal Democrat initiatives on food labelling. Is it not about time the Government stepped up to their duty to match the Opposition parties' determination to deliver the right food labelling laws for the people of our country and to lead on the issue in the rest of Europe? My submission is that, with our experience and expertise in food labelling, this country should seek to lead Europe on that issue. If passed, my Bill would enable the Government to adopt a trail-blazing line in their continuing, but tortuous—with no timetable or sign of a speedy or even timely resolution—discussions with Europe. This country's food labelling laws could be the standard for the rest of Europe. I am sure that our European partners would welcome our initiative and leadership.
I learned to my surprise that when the Minister of Agriculture made his cheap and churlish remark about my Bill, he had not taken the trouble to read it. Since then, he has had it impressed on him by consumer and producer organisations outside the House, which have a great interest in my Bill becoming law, that it is a serious proposal for a series of measures that deserve close and sympathetic attention and support from the Government.
I was therefore pleased to see that a spokesman for the Ministry of Agriculture, Fisheries and Food had responded to a journalist's request for a comment the day after the Minister's remark in the House. When asked about my Bill, the spokesman said that MAFF was
sympathetic to what Mr. O'Brien is trying to achieve.
On the EU and its relationship to the Bill, I do not understand how it is possible for clause 3 to be in contravention of EU law when all the UK's food production and animal welfare standards comply, at the very least, with all applicable EU laws and regulations.
As we know, not only do we police and enforce those regulations rigorously—in contrast, sadly, to many of our fellow member states—but we implement them sooner. Witness Denmark and its decision not to implement, under the same EU directive applicable to us, the banning of stall and tethered pigs until 2006 or 2007.
The UK has an honourable record of going much further than the EU directive in animal welfare measures. The Government can be concerned about EU law contravention only where we go further, with higher food production and animal welfare standards.
If that is so, are the Government honestly saying that for the sake of keeping sweet with our European partners, we must allow into this country food products whose production and animal welfare standards are inferior to those imposed on our own farmers and other food producers?

Sir Nicholas Lyell: I am listening carefully to my hon. Friend, and I am sure that he is not suggesting that we should stop food products coming in if they comply only with EU standards. The point that he is making so effectively is that we are entitled to have higher standards in this country. Under EU law, a member state is always so entitled. All that his Bill asks is that consumers should know whether the product that they are choosing complies only with EU standards, or also with the higher UK standards.

Mr. O'Brien: That is exactly right. The terms of the Bill have been deliberately designed, in my best attempt to keep them simple, clear and honest, to give information. The Bill is not prescriptive or penal. I find it baffling that the Government might not allow the Bill and clause 3 to progress. It is critical that our consumers are aware of products whose production and processing has been inferior to the standards applied in this country.
Existing EU law is flexible in its interpretation—a point that has been touched on. For instance, as part of the Agriculture Minister's doomed attempt to appease the French Government over the illegal ban on British beef, the Government acceded to French demands that British beef should be labelled with its country of origin. The European Commission ruled that that was legal under EU law.
We are not alone in wanting the Government to stand up for our national interests within the EU. I shall not take up the time of the House with the Swiss example of negative labelling as Switzerland is outside the EU and the measure would indeed contravene EU law, which my Bill avoids, but I shall highlight the example of Sweden—an EU member state, that has not been taken to the European court.
Swedish Farm Assured—SFA—announced on 28 October last year that all meat products bearing the new SFA logo would be traceable by consumers with internet access. An individual code on each packet would allow a consumer to visit the SFA site, www.healthy-tasty.com, trace the product back to the specific Swedish farm on which it was produced, and find out
about the method of its production and transportation to the shop of purchase.
Announcing the scheme, SFA stated:
We believe that to be competitive in this market we have to provide something extra—to us that means consumer confidence. SFA can provide detailed information on where food comes from and how it is produced.
Perhaps the most telling example is the latest French one. Mr. Jacques Lemaître, president of the National Pork Federation in France, and Mr. Jérôme Bédier, president of the French Federation of Commerce and Distribution, signed an agreement of intent on 9 February to allow the identification of the origin of pork sold throughout retail outlets in France. The arrangements will initially apply only to fresh pork, but it is intended that they will be extended to processed products in due course. Under the scheme, traceability is assured throughout the stages of production, slaughtering and processing, and retail outlets will provide the information. That is expected to be possible for approximately 85 per cent. of the pigmeat that is currently produced in France. Mr. Bédier said:
This is a natural development stemming from what has been put into place for fruit and vegetables and—
pitifully, as we know—
for beef. Consumers want to know more and more about the origin of the products they buy.
Mr. Lemaître said:
Meat producers are quite happy for the customers to know where their animals come from; it is an important factor in gaining confidence in our products.
There is also the amazingly termed "swine stamp" in Brazil. That is relevant because of the World Trade Organisation for the global marketplace in which pigmeat competes. The Swedish and French examples also state that they believe that their new provisions conform to WTO requirements. Unlike France and Sweden, will the United Kingdom, under this Government, impede our producers' competitiveness while the next trade round grinds on? If so, liberalisation without better food labelling will mean that any producer who does not produce to the lowest cost will be lost in the price-driven global marketplace.
Clause 4 covers the method of marketing or labelling foods. It provides that food for sale should show the information that the Bill requires
on the food's packaging; on a label attached to the food's packaging; on a label that is clearly visible through the food's packaging.
That is straightforward. As we know from the plethora of labels that bombard consumers about other matters on foods, and in the instances of good practice under voluntary arrangements, information about country of origin and standards of production is sometimes seen.
Clause 4(1)(d) covers foods that are not pre-packed or packaged. It would require a shelf marker or show card in a clearly visible location. The provision relates to loose goods such as fruit, vegetables, and jointed and cut meats in butchers' shops.
To ensure accurate, reliable and therefore honest information at the point of sale to the "ultimate customer"—the defined term in the food labelling regulations of 1996—clause 4(2) covers circumstances in which food is sold on in the wholesale chain. It provides that the information required by the Bill appears on the "outermost packaging" of the wholesale pack of food. It encourages, but does not make mandatory, the provision of that information in commercial documents, which relate to the food. That information is currently known and, in today's commercial world, it is often held electronically by individuals and enterprises in the supply chain. Clause 4(2) tries to ensure that the information is simply captured and passed along the chain in a clear, reliable and honest manner.
Some retailers have expressed the anxiety that the Bill would mean extra cost. I do not believe that, because the information is factual and has to be known by all parts of the supply chain. Ensuring that the information is captured, collated and printed on labels throughout the supply process is simply an administrative matter. There are examples that show that such labelling is easily possible. Ten days ago, the Tesco chain, which has launched a scheme to help British farmers to sell more produce in the 650 Tesco stores, agreed to label clearly the country of origin under the Tesco farming initiative 2000.
Extending such a scheme countrywide will require the force of law, and I am in discussion with a company that has compiled a database of all ingredients of all foods. It tells me that data on country of origin and methods of production are readily available. In today's information technology world, it is economic and reliable to access, use and display the information.
The Bill intends to achieve simple and clear, as well as honest, labelling. Consumers do not want to be faced with a mass of information that is difficult to interpret or requires too much time to assimilate. Although this is best left to detailed consideration in Committee, discussions that I have held with all sections of the food industry and, above all, with consumers, suggest that accreditation through, for example, a kitemark, may be the best way in which to proceed.

Mr. James Gray: Would not a Union jack be enough?

Mr. O'Brien: A Union jack is always a welcome sign to—I hope—all hon. Members. However, it has been abused in recent times. Examples of that have already been given. We need to think of something new that would engender absolute confidence. That is the point of the Bill, welcome though I always find the Union jack.
A kitemark that can be protected, policed and not abused may be the best way to proceed. In addition, quality could be certified by labels such as ENG for England and WAL for Wales or, in due time, SCO for Scotland and NI for Northern Ireland. They could provide

accreditation and certification that the food came from a particular country or region of origin and had been produced according to its production standards—that is, the minimum legal requirements applicable to that food in that country.
There has been considerable discussion and that has led to the National Farmers Union, Tesco and others taking action to develop a British farm assurance mark—a kitemark aimed at informing shoppers which food products are reared or grown nationally. That approach would also help to cover the other example addressed by clause 4: food sold to consumers by catering establishments.
Subsection (3) would ensure that consumers being served food in catering establishments would have the opportunity to inform themselves of country of origin and standards of production either before or when that food was presented. Restaurant menus would not be required to carry a food label for country of origin and standards of production for every item, but they would be have to carry—as is already the case for genetically modified foods—a statement, kitemark or other emblem stating the country or countries of origin of the major ingredients of all items and whether production standards inferior to this country's might have been involved.

Mr. Gerald Bermingham: I have been listening to the hon. Gentleman for a little while and I am puzzled by clause 4(3). Is he saying that menus would have to say whether an item contained monosodium glutamate, E numbers and everything else? That would run to pages before a customer got to the list of food.

Mr. O'Brien: The hon. Gentleman's point would have been valid had he been in the Chamber a little earlier, although I am sure that he was kept away purely by other commitments. The provision would apply only to major ingredients—ones that form 25 per cent. by weight of a food. I made that point previously and, if there is any deficiency with his learned skills in respect of interpreting the Bill, I should make it clear that that is certainly what is intended. However, I must say to him in all candour that I am not convinced that the Bill's drafting necessarily achieves that aim as there is a doubt: catering organisations may not be consumers in the normal sense of the word and restaurant meals may not be precisely food "presented for sale", which would therefore be labelled in the manner envisaged under the Bill. Again, I would welcome the House's assistance.
Clauses 5 and 6 deal with normal matters and I draw the House's attention to the fact that Mr. Alex Johnstone has introduced to the Scottish Parliament a Bill relating to meat labelling and country of origin. There may be difficulties in this example between England and Wales and Scotland following devolution—let alone between this country and the rest of Europe—but, timetabling and the approval of both Houses of Parliament permitting, the two measures could ride in tandem and ensure a level playing field.
I shall move toward a finish. As I have taken a number of interventions, my speech has run on a little longer than I expected.

Angela Smith: Will the hon. Gentleman take a further intervention?

Mr. O'Brien: Yes.

Angela Smith: We are approaching the end of our proceedings and I may have the opportunity to contribute so I should be grateful for the hon. Gentleman's comments on the drafting of the Bill. Clause 3 refers to when
production standards for that food are different from, and less demanding than, the production standards applicable in England and Wales.
I am not sure whether that wording would stand up in court. Has it appeared in any other legislation and does he have examples? Is he confident that it will work?

Mr. O'Brien: I am not aware that those particular words have been lifted from existing legislation and it would be a legitimate matter for the Committee to consider. I believe that they were the most felicitous words that I and others could devise to ensure that we give effect to the Bill's principles and clause 3 in particular.
The Government are clearly aware of the great concern among consumers. Their spokesman in the other place, Baroness Hayman, recently launched a consultation on food labelling that happens to coincide with the debate on the Bill. She has said that she believes that consumers have a right to clear, informative labels to help them make "informed choices" about foods.
It is clear what consumers want, so why wait? The Government should use the opportunity of the Bill to deliver what consumers and producers are crying out for on food labelling. I do not believe that it is necessary to wait for yet another consultation period. The Minister for the Cabinet Office said on the "Today" programme this week:
I don't yet trust the labelling that I see on foods.
She also said:
We have got to have clear labelling for people to make their own choices.
The Government now have a chance to do that.

Mr. Tyler: The hon. Gentleman has quoted a number of Ministers, but I wonder whether he has carefully considered the Prime Minister's speech to the National Farmers Union, the main theme of which was the importance of ensuring that British consumers have access to good quality information about good quality food. That is also the theme of the hon. Gentleman's Bill.
I shall take this opportunity—as I may not get another—to quote the Prime Minister on that occasion. He said that the Government envisage
a trebling of the area under organic farming by 2006.
The Prime Minister's words may come to haunt him if the Government do not give the hon. Gentleman's Bill—and, dare I say it, my Bill—a fair wind.

Mr. O'Brien: I am glad that the hon. Gentleman's intervention gave him the opportunity to cover a slightly wider point, but I shall not pursue that, Mr. Deputy Speaker, for fear of losing your support.
I intended to refer to the Government's present policy on genetically modified foods. However, I am conscious of the time and others want to contribute, so rather than go into that in detail I shall just cite the phrase, what is sauce for the goose is sauce for the gander. What is sauce for GM foods must be right for other foods: they should also have labelling information about the country of origin and standards of production. If GM food is about anything, it is about standards of production as much as about ingredients. However, I shall refrain from commenting on what some call the Prime Minister's policy U-turn on GM foods.
My Bill would protect the well-being and freedom of choice of our citizens, and, above all, the health and safety of our children, who eat every type of food. It would lend great weight to this country's proud tradition of leading the world in animal welfare. It would be viewed positively by everyone, and is a rare chance for the House as a whole—and the Government if they truly care about honesty in food labelling—to achieve a political win-win. I commend the Bill to the House, and I hope that it has a speedy passage on to the statute book.

Mr. Tony McWalter: I am grateful to you, Mr. Deputy Speaker, for allowing me to contribute to the debate. I welcome the initiative of the hon. Member for Eddisbury (Mr. O'Brien), and I am grateful to him for echoing a question that I asked the Minister of Agriculture, Fisheries and Food about the labelling of pigmeat.
The Bill is somewhat schizophrenic—and I am not sure whether a Committee can sort out schizophrenia. If I am asked to serve on the Committee considering the Bill, I hope that I can do my bit to put the patient in a better state. Those are slightly harsh words, but I think the Bill has a Euro-clobbering dimension, even though that may not have been intended. To get the Bill to be more Euro-compliant will prove quite taxing, although there is absolutely no doubt that the current labelling regime is highly prejudicial to British farmers and British agricultural production.
I have already given the House a brief account of my experience in trying to buy British bacon in a Somerfield supermarket in Stevenage, and I now have the opportunity to mention it at greater length. There was a cabinet full of bacon, but it proved almost impossible to buy a product that was recognisably compliant with the high standards of British pigmeat production that the hon. Gentleman rightly wants to protect. I found the words "produce of Europe", in minuscule characters, on most items; in other cases, it was "Dutch", "Danish", or something else. It was difficult to find any British bacon—but there at the bottom of the cabinet was a packet on which "Wiltshire cured" was written in extremely large letters. When I picked it up, I saw yet again, in the tiniest possible writing on the underside, "produce of Europe". I do not think that that necessarily meant that curing in the Wiltshire style had taken place in Wiltshire, and it certainly did not mean that the pigs had been reared in a way that complied with this country's higher standards of animal welfare. Eventually, I managed to buy some organic bacon at the store down the road.
We are told that there are currently 31 protected labels—"Wiltshire cured", "Newcastle Brown", "Scottish salmon" and so on—but that does not alter the fact that


there are far more than 31 misleading labels. It is a nightmare for the trading standards officer who genuinely wants to prevent consumers from being misled, and, because the Bill makes a real effort to confront the problem, I welcome it. I did, however, describe the Bill as schizophrenic, and I want to identify some of the problems associated with it.
Clause 2—which is, in a sense, the core of the Bill—states:
Food which is sold to a consumer shall be marked or labelled with … the country … of origin.
Currently, British producers have every right to tell consumers that their food was produced in Britain: indeed, they have the capacity to use any kind of labelling that they want to use, as long as it is not regarded as market-obstructive.
I have much sympathy with those who are angry about the fact that the Union jack can be used by those who merely packaged the product at the end of the process. Let me say in passing that in one part of the United Kingdom, Northern Ireland—which, admittedly, is not directly affected by the Bill—the Union jack, unfortunately, has other connotations. Producers there have tried to get around the problem by featuring a bunch of violets in an attempt to convey a Northern Ireland identity; but most people in Northern Ireland still do not know what the logo really means.
That is the difficulty with labelling. What does a logo say about the product? Requiring a product to be labelled with the particulars of its country of origin is very different from permitting it. Under the Bill, if producers in America, for instance, have not stated on the label that 28 per cent. of the product comes from Mexico, 32 per cent. from Peru and the rest from the United States, the food in question will not be eligible to be sold. I deliberately cited countries outside the common market because strong country-of-origin regulations often apply to products imported to the European Union, although the Bill does not really deal with whether those regulations are consistent with the regulations mentioned in it.
Again, in the EU itself, the Bill might take us well out of kilter with what other countries would expect. The Bill's emphasis and compulsion would mean that such a product would not be eligible to be sold in this country. Obviously, it would be a strongly restrictive way in which to deal with the matter.

Mr. Letwin: indicated dissent.

Mr. McWalter: I see that the hon. Gentleman is expressing dissent. I will be happy to take an intervention if he thinks that I have got something fundamentally wrong.

Mr. Letwin: I am grateful for that invitation as I was about to ask the hon. Gentleman to allow me to intervene. I do not understand why he believes that it is restrictive to force people to declare what they are selling. Regarded in its positive light, what is the nature of the restriction in the Bill?

Mr. McWalter: If we could introduce the policy in an all-European Union way, one bit of the EU would not say,

"You must meet some additional condition that you do not have to meet in the rest of the market." The Government's general aim is to achieve an all-EU system of labelling, working through the Codex committee to get the whole of the EU to agree on co-ordinated rules about country of origin—but if one country decides to make it 33 per cent., and another, 50 per cent., that will introduce precisely the constraints on market lubricity that the free market was designed to avoid.

Mr. Letwin: I accept that both from an international point of view under Codex and in relation to the EU itself, there is every advantage in universalisation. No one is challenging that. The question is: in what sense is it a restriction? Where is the precedent for supposing that it is a restriction in law to force transparency concerning country of origin, or any other marking? I know of no such instance.

Mr. McWalter: It would be a restriction if other countries, in producing and labelling their products said, "Gosh. We cannot now send the product to Britain because it has imposed an extra condition." Perhaps they have not been so careful about their tracing, which, as we have heard, is at least possible in places such as Sweden, so there is an element of compulsion.
I want British consumers to get to the position where, instead of being confronted by a cabinet full of stuff and having no idea where it came from, or what the welfare conditions governing its production were, they know about the products and can support British farmers. However, if we are to make the Bill Euro-compliant, as opposed to Euro-clobbering, we may have to be much more careful about such unilateral compulsion. The Committee will have to examine whether it can get round that potentially major difficulty.

Mr. Stephen O'Brien: I emphasise that there is no attempt on my part to engage in any Euro-clobbering. In response to the hon. Gentleman's intervention, I said that Euro-compliance would be required, but, although I acknowledge the technical and cogent point that was made by my hon. Friend the Member for West Dorset (Mr. Letwin), the issue is about leadership. Europe is looking for a steer. We have the expertise and experience to give that leadership. What really concerns me—the hon. Gentleman's comments do so, too—is that the Government, by failing to support a Bill that would provide an opportunity for change, are hardly demonstrating that they wish to go any faster than at the slowest pace, supporting the lowest common denominator of the EU. My feeling is that, on this issue, we have a real opportunity to demonstrate leadership, and that others will want to follow us.

Mr. McWalter: I am not convinced that the hon. Gentleman is quite right about that. The Government are taking a lead on the labelling initiative precisely because of the major difficulties precipitated by the BSE crisis and other events. Nevertheless, I think that the hon. Gentleman's Bill will help in achieving the objective that he described, and that the Bill and this debate are a wonderful mechanism for concentrating Agriculture Ministers' minds, so that, when next we ask them questions, they will be able to show that they really are giving such a lead.
I am sorry to say that clause 2 is undoubtedly not Euro-compliant. However, I look forward to debating that point in Committee and to examining the relevant European statutes, to determine whether there is a way in which the sense of the clause could be reformulated and reintegrated into the legislation.
Some countries will say that, for some products, country of origin is not a relevant issue. Clause 2 would require every producer of every commodity to provide a type of traceability. Such a requirement should not apply to many products, and producers would regard one as only an incumbrance and an irrelevance.

Mr. Bermingham: Before my hon. Friend leaves clause 2, I should like to deal with the matter of a 25 per cent. threshold. Clause 2(1)(b) states that
where the food has more than one ingredient, particulars of the country or countries of origin of each major ingredient
must be included on the label. In jam or preservative, for example, 40 or even 50 per cent. of the ingredients may come from one country, whereas the other 50 or 60 per cent. come from five or six other countries. The label would be wholly misleading if it said that the product was English, as it could be made essentially from ingredients from France, Germany and elsewhere.

Mr. McWalter: I was not planning to dwell on clause 2(1)(b), but my hon. Friend's point is correct. However, I think that the Bill would require only ingredients meeting the 40 per cent. threshold to be labelled. I might also add that such a jam would be rather luxurious compared with those that are usually found in my household.
Clause 3 is currently very unsatisfactory, providing for labelling of food that has been produced to a quality that is "less demanding than" those applying in England and Wales. It is a clear example of how concentration on one commodity—pigmeat—could create major difficulties for other products. We all think that—although there is still room for improvement, and there is an awful lot more room for improvement in mainland Europe—British pigmeat and bacon are produced to the highest animal welfare standards.
Let us, however, consider the case of chocolate. If the provision in clause 3 were applied elsewhere, the Belgians, for example, could say, "Your chocolate is not chocolate at all. Furthermore, your product is produced to standards less demanding than ours." The Belgians would require us to label our inferior chocolate stating, "This is not chocolate", or "This chocolate is produced to lower standards". Some time ago, I had the pleasure of visiting a Belgian brewery. The Belgians were strongly of the view that their production methods resulted in beer of an infinitely higher standard than our British methods. Although we all know that our British beer is massively superior to Belgian beer, they feel that the hygiene standards and the quality of the hops that they use meet much higher specifications.

Mrs. Janet Dean: As I represent Burton, I must say that the quality of water in Burton produces our excellent beer.

Mr. McWalter: I am grateful to my hon. Friend and I agree that we should have the highest regard for the quality of water in Burton, particularly when it has been

adjusted in a British brewery. However, attempting to assess whether a product is produced to a more or less demanding specification lands us in one hell of a mess.
Clause 3 states that if food is produced to a less demanding standard,
a reference to that fact shall appear on the mark or label of that food.
So the manufacturer has to state on the label that the food has been produced to standard B or standard Z rather than describing the production method. It is unfeasible to expect manufacturers of products to state explicitly that they produce lower-quality products.
Having talked about the schizophrenic character of the Bill and drawn attention to the provisions that seem particularly Euro-clobbering—

Mr. Bermingham: In relation to beer, has the hon. Gentleman considered the position of McEwans brewery in Scotland having to label its beer as being of a lower standard than English beer? That would cause a riot.

Mr. McWalter: I take my hon. Friend's point. The reference to beer has got several of my hon. Friends extremely excited. Opposition Members have not joined in, but I have no doubt that they are also experts in the subject. Be that as it may, it is clear that the proposal would create difficulties.
Let me draw another dimension of the Bill to the attention of the hon. Member for Eddisbury (Mr. O'Brien). Some mechanisms in Europe might achieve his aims without violating European law. In Italy, there is a chain of supermarkets—I think that it is called Italmart—that sells only Italian produce: its wine counter, for example, sells no French or German wine. That method of favouring domestic production does not seem to fall foul of European regulations. Perhaps we should have a supermarket called Anglomart.
The current voluntary system of labelling gives people the opportunity to exercise choice. The hon. Gentleman may have missed one crucial point. We must establish a distinction between requiring people to label goods and prosecuting people if they label them in a misleading way or make an untrue claim about a product's ancestry—for example, by giving the impression that a brand of gin comes from Plymouth when it has never been near that part of the country. Incidentally, I believe that that label is one of the 31 protected labels.
It is important to prosecute those who mislead, and to encourage, support and give Government help to those who wish to provide labels that will allow people to exercise their choice of British products produced to a higher specification. At the same time, we should try to make progress in achieving better labelling throughout Europe. The Bill contains some useful provisions, but after it has been rid of its schizophrenic character, I suspect that some of its clauses will no longer be with us.

Mr. Andrew Stunell: I speak as a sponsor of what is a good Bill. It will be popular with consumers and producers, and the hon. Member for Eddisbury (Mr. O'Brien) drew attention to the fact that it had received the specific support of and co-operation from the Consumers Association and the National Farmers Union. My constituency is not primarily an agricultural


one, but I have pig producers and farmers in it, and they have been desperately hard hit by the agricultural crisis affecting the whole country. I well understand that other hon. Members have much wider experience of the problems, but I wish to emphasise that we face a practical problem now and the Bill is not simply an academic exercise.
The Bill is popular without being populist and would have several desirable outcomes. I wish to comment on some of the incipient criticism of the Bill that it is in some way Europhobic. If my reading of the Bill had suggested that, I would not have been a sponsor of it. Although I hate to say so, perhaps I am to some extent an alibi for the hon. Member for Eddisbury, should he come under fire from some hon. Members on that point. I do not doubt that some people will support the Bill for Europhobic reasons, but that is nothing to do with me, guv.
The hon. Member for Hemel Hempstead (Mr. McWalter) has had the clearest assurances—ones that I would also wish to hear—that it is the intention that if the Bill goes forward, endeavours will be made to make it Euro-compliant. There is no point spending time and passing legislation that is not. I would be just as disappointed if the Bill were to be kicked into touch because it was thought to be Europhobic as I would be if I thought that it was receiving support because it was Europhobic. We need to make it clear that the Bill is not about Europhobia, it is about protecting British production, industry and consumers, and ensuring that an element of informed choice is available to those who purchase from shops in this country.

Mr. Tyler: I endorse the point that my hon. Friend has just made. Does not the fact that other member states have similar legislation give the lie to the suggestion that the basic premise for the Bill is Europhobic? Those other member states have greatly benefited their consumers and producers as a result.

Mr. Stunell: That is true, and we have already heard about the provisions being made in Sweden and France and the retail method of tackling the issue in Italy. Perhaps some entrepreneurs may read Hansard and see an opening for such retail practice in this country. For every member state—and others, such as the Swiss—there is a serious issue in ensuring that consumers have the knowledge to make an informed choice about the food products on sale. The Bill goes a long way in the right direction to achieve that.
I am a keen supporter of what might be called the European project, which I hope will go forward further and faster. However, I do not believe that every rule and regulation currently in place is right. I am not afraid to say when things are wrong and need to be changed. It is clear that gaps and deficiencies exist in the regulations covering food retailing, standards and labelling. I am happy to support the Bill, as it will push forward the process of correcting those deficiencies.
The hon. Member for Hemel Hempstead made a valid point when he said that the Bill offers an opportunity to exert a little pressure on the Ministry of Agriculture, Fisheries and Food to be more proactive. The hon. Member for Eddisbury said that he wanted the

Government to take a lead in European negotiations on labelling. I hope that the Minister will assure the House that that is exactly what the Government are doing, and that they will use the Bill as leverage in those negotiations. I hope that they will tell their European counterparts, "We've got trouble at t'mill, and the lads aren't happy. There's a Bill going through Parliament and we need to press the case it makes." The Minister should not reject the reform proposed by the Bill, but embrace it and take it forward.
The Bill is not perfect. I am exploring the wording of a ten-minute rule Bill that I want to introduce on retail packaging, and I have discovered that the matter is not as easy as I suspected. The hon. Member for Eddisbury is to be congratulated: he has arrived here in a flash of light after the Eddisbury by-election and produced out of his back pocket a Bill that is good, even if it is not perfect.
The Bill is a worthwhile step in the right direction. I support it and am happy to sponsor it. It is certainly good enough to merit a Committee stage.

Mr. Bermingham: The substance of the Bill can be found in clauses 2 and 3. Will the hon. Gentleman tell me how any court in the land would interpret clause 3(1)? Against which codes, practices or other measures will the qualitative standards of clause 3(2) be set? Clause 3 is a nightmare.

Mr. Stunell: The hon. Gentleman seems to have made an eloquent plea for inclusion in the Committee that will consider the Bill. I should be more than happy to serve on the Committee with him, which would mean that we could debate the point in more detail.
The Bill is not perfect, but it is good enough to go into Committee and for the Government to use as a lever in Europe. I urge them to do so.

Mrs. Janet Dean: I am pleased to participate in this debate, as the many farmers in my constituency are very worried about the present state of agriculture. They, and the consumers in my area, are keen to ensure that good and fair labelling accurately sets out the country of origin of produce on sale in shops and supermarkets.
My only reservation about the Bill has been expressed by other hon. Members, and it has to do with its compatibility with EU law. The National Farmers Union wrote to me and emphasised that
the application of the legislation to the selling of food to catering establishments as opposed to supermarkets and other shops are technical issues which can be examined closely at a later stage in the parliamentary process.
I should be interested to hear from my hon. Friend the Minister whether that is a possibility.
I was reassured by the hon. Member for Eddisbury (Mr. O'Brien) that he was not trying to skirmish with the EU. I can understand that that might be the reason for a Bill such as this, as many Opposition Members seem to believe that this Government have invented the current crisis in the agriculture industry. We are picking up the pieces of many years of problems in the industry, and labelling is part of that. It comes from the problems of BSE and the fact that, thankfully, we have brilliant welfare standards. I have visited pig farms in my constituency where the people who work with the animals are delighted that conditions are now better.
The better welfare standards that this country enjoys, certainly for pigs, were extra to the European requirements. We implemented the regulations to a higher standard than was the case in other parts of Europe. That is sometimes misinterpreted to mean that other European countries are behind us. They are, but that is because we chose to implement the proposals as we did. I am pleased that we did, but unless we sell and market our produce here, showing that we produce the animals according to better standards, our farmers will be at a disadvantage against their European competitors.
The situation in agriculture is desperate, as Ministers are well aware. I welcomed the announcement at the beginning of February about tightening up the labelling guidelines. We all want to be able to go into a supermarket and know what we are buying and where it comes from. It is difficult to look at bacon on the shelves and know, without studying it—perhaps even getting the reading glasses out, for those of my age and older—where it was reared and processed.
The news this morning referred to the launch today of farmers markets in London, with the Minister of Agriculture, Fisheries and Food in attendance. That is an important initiative which has been adopted in my own constituency. It provides the opportunity to consumers to buy direct from farmers in this country and know where their food is coming from. Supermarkets are also being pressed to ensure that their labelling is correct.
My hon. Friend the Member for Hemel Hempstead (Mr. McWalter) touched on my next point. If the Bill were enacted and we labelled our food in accordance with its provisions, could we insist that other countries labelled theirs similarly? As my hon. Friend said, it is not a case simply of Europe but of the rest of the world. Could we tell American producers to label their products in a certain way to sell them in the United Kingdom? Or would the Bill affect only food produced in this country? Is there any difference between what the Bill would do it if referred to labelling British produce only, the Swedish Farm Assured mark, the recent NFU kitemark initiative and the Meat and Livestock Commission Quality Standard Pork Mark? Would not the Bill simply duplicate what the NFU has already done?

Mr. Stephen O'Brien: I wish to clarify the position. The Swedish Farm Assured mark specifically includes the method of production in the information. Traceability includes being able to check on the methods of production in a positive and factual sense. That is the difference between the Swedish scheme and the NFU's current proposals for a kitemark.

Mrs. Dean: I would have thought that the NFU's kitemarks would be designed to show that the product was British and had been produced according to the standards of this country. Therefore, it would differ little from the Swedish system. However, I am willing to receive further information on that.

Mr. Bermingham: I am listening carefully to my hon. Friend. From the wording of clause 2, I assume that any food sold in this country would have to bear a label showing the country of origin and the country of

manufacture. The NFU's point about kitemarks is a good one. We would know for certain whether food was English produced and manufactured.

Mrs. Dean: I fully support the NFU's proposals for kitemarking and I congratulate it on its initiative. I also welcome the Government's intervention in trying to ensure that we know the country of origin of the products that we buy in our supermarkets. I welcome any proposal that would help agriculture in this country and the farmers in my constituency.
If the Bill progresses, I hope that it will be practical and will meet EU regulations. I question whether Swedish Farm Assured is any different from the NFU kitemark. It is important that we do all we can to help farmers. I look forward to hearing the Minister's comments.

Mr. Oliver Letwin: I do not want to speak for more than a few minutes because I have somewhat justifiably been accused of volubility. We have already debated the Bill for some time, and I am anxious to see it proceed.
I wish to make three brief points. The first is purely technical. I do not understand the arguments of the hon. Member for Hemel Hempstead (Mr. McWalter)—which were made in good faith—that it would be a restriction of trade to impose transparency requirements where there is a non-differential. I do not believe that the jurisprudence would support that interpretation and my right hon. and learned Friend the Member for North-East Bedfordshire (Sir N. Lyell) does not believe it. However, the hon. Gentleman may be right and the answer can be teased out in Committee.

Mr. McWalter: If one buys a packet of peanuts, the label often says that they are the product of several countries. Nobody is that fussed about which countries they come from. Such products might need a wholly different tracing system if they are to arrive on our shelves at all. That is just one example among many where the country of origin is not currently made known.

Mr. Letwin: The hon. Gentleman neglects the fact that a particular measure—this is as true under the Codex Alimentarius as it is under the European provisions—that imposes a cost on producers is not a prima facie reason for classing it as a restriction of trade if the effect is non-differential between the imported and the home product. I do not understand why the hon. Gentleman takes the view that he does. Much more importantly, I do not understand why the Ministry of Agriculture, Fisheries and Food takes it. It will have its reasons—they are probably not the hon. Gentleman's reasons—but I think that it has been misadvised. However, that point will come out in Committee and I hope that it will eventually be satisfactorily resolved.
My second technical point is about clause 2. I think that my hon. Friend the Member for Eddisbury (Mr. O'Brien) would probably agree that the rest of the Bill could be ditched if clause 2 could stand. It is the bit that matters. We want to ensure that people are not misled—I use that word advisedly—into buying things that they think are produced in Britain, but are not in any layman's definition


produced in this country. That aim is shared with the Ministry and with the Prime Minister, to judge by their comments, and I take what they say at face value.
If a restriction in trade is imposed as a result of the form in which the aim in clause 2 is achieved, many other modalities are feasible. One, for example, would be to reverse the burden of the clause, and make it a ban on people labelling food in a certain way—such as labelling it "British"—except in certain circumstances. That would avoid imposing on people who import goods the necessity of labelling them as having come from other places. There are thousands of such modalities, and no doubt much drafting work can be done, but I do not have the slightest doubt that clause 2 could be drafted to be entirely consistent with the Codex, with European regulations and indeed with the spirit of competition.
My third point is overwhelmingly the most important. Normally I try not to speak in terms that are pejorative or party political, beyond the genuine disputes between us about matters of policy. However, on an administrative basis, there is a disgrace. It is acknowledged by all parties that the Bill seeks, however hamfistedly and improperly—we shall find that out in Committee—to achieve an aim that the Agriculture Minister and the Prime Minister are on record as seeking to achieve.
It is not as if the Bill descended on the House two and a half hours ago without prior notice. It was published, and it was known that my hon. Friend the Member for Eddisbury would introduce it. The Ministry had ample opportunity to approach my hon. Friend, my right hon. and learned Friend the Member for North-East Bedfordshire and other colleagues who are concerned with these matters and who have corresponded extensively about it, and talk through the Bill.
When I assisted in the promotion of the Referendums Bill as a private Member's measure, I received exactly that courtesy from the Home Office. It contacted my colleagues and I and we discussed the Bill. We did not reach an agreement, but at least there was a constructive effort between the Department and the Bill's promoter to turn it into the best possible Bill in the Department's view, within the limits of the promoter's willingness. It could then be debated in the House. My hon. Friend assures me that no such process occurred in this case. Why not? Why has not the Bill been redrafted in such a way that it comes as close as possible to being compliant? There is no excuse for that when the Agriculture Minister maintains that he cares about achieving that result.
I am sure that the Minister of State will tell me that she and her colleagues spent a great deal of time with bureaucrats in Brussels trying to improve things, and I have no doubt that that is true and that Ministers have genuinely been trying to get a European result. However, here we have a potential UK-based result that may take effect much sooner, and the Ministry has failed to take it seriously. That will be recognised as a disgrace by farmers in my constituency and those of other Members from all parties. It is an extraordinary and unreasonable way to conduct these affairs.
I am grateful that I am not the Agriculture Minister and so are farmers. I accept that he has a ghastly role. However, if I were the Minister, the first thing that I would have done when I heard that my hon. Friend was

promoting the Bill was to call him in for a chat and ask, "What are you trying to achieve, and can we achieve it?" This is an ideal opportunity; it is a legislative slot.

Mrs. Dean: Does the hon. Gentleman know whether the hon. Member for Eddisbury (Mr. O'Brien) contacted the Ministry to seek advice before he drafted the Bill?

Mr. Letwin: No, but no less a body than the National Farmers Union did so on my hon. Friend's behalf. It is pretty extraordinary that although the Minister knew that the Bill was being supported by organisations representing farmers interests, such as the NFU and the National Pig Association, as my hon. Friend showed, and by consumers interest groups, he did not try to iron out problems in the Bill as far as possible before this stage. I accept that the Standing Committee will do more.
The Government must want the result that the Bill would achieve, so I can only assume that they have become so terrified of any domestic action that they simply bring down the barriers on any discussion of domestic action. All activity must be focused on discussions in Brussels and other Governments in the Codex. That is an extraordinary error of judgment and a bad way to go about administration.
We have the opportunity to take domestic action that will have an immediate effect. Even if there is a scintilla of doubt about the Bill's compliance and it is challenged, that challenge will take many years. I am sure that the Minister of State knows that it would also take many years for her to persuade Governments in the EU and the Codex negotiations to change anything material. We are dealing with a contrast between fast action and slow action and the Ministry has decided to shred the fast action and go for the slow action. That is particularly bad because the Prime Minister and the Agriculture Minister should not be saying that they want urgent action when they are ensuring that there will be no urgent action.

Mr. Bermingham: The hon. Gentleman heard me say earlier that clauses 2 and 3 are extremely badly drafted; they will not stand up in any court of law. Would he not be sensible to persuade his hon. Friend the Member for Eddisbury (Mr. O'Brien) to withdraw the Bill until someone can redraft those clauses?

Mr. Letwin: The hon. Gentleman might well be right to say that clauses 2 and 3 are badly drafted. However, first, the Ministry had the opportunity to help to redraft them before the Bill was introduced; and secondly, the clauses can still be redrafted—the mistake can be cured in Committee. There is no reason to withdraw the Bill, whereas there is every reason to press ahead with it and find out whether something can be fashioned. It is up to MAFF to exert itself to get the Bill into as good a shape as possible. If, contrary to advice received from the House of Commons Library and relevant QCs, it turns out to be genuinely impossible to fashion legislation that will work, my hon. Friend the Member for Eddisbury and I will both accept that. However, that is not what has happened so far and the dereliction of duty that has occurred must quickly be redressed.

Mr. McWalter: I seems to me that, in many ways, today's debate has moved matters on to the point where we feel far more confident that there is a sense of unity


and purpose. I hope that the hon. Gentleman will lose his enthusiasm for lambasting and get on with the work of advancing the debate.

Mr. Letwin: I take the hon. Gentleman's point. If the Minister tells us that the Government will now adopt a constructive attitude to the Bill, I shall be happy to withhold further lambasting. My lambasting is to be regarded in an historical light if, as I hope she will, the Minister tells us that the Government intend to proceed in a spirit of conciliation. In pursuit of that fresh spirit, I shall now sit down.

Mr. Tim Yeo: I warmly congratulate my hon. Friend the Member for Eddisbury (Mr. O'Brien) on his success in the ballot, on his choice of subject—one that is of great interest to every consumer and farmer in this country—and on his excellent and lucid speech in which he dealt convincingly with most of the objections raised. No one who has spoken in this excellent debate has attacked the principle of the Bill; the concerns expressed have been about points of detail. I was glad to hear the hon. Member for Hemel Hempstead (Mr. McWalter) say that he hoped to serve on the Standing Committee; I, too, hope that that will be possible.
As ever, my hon. Friend the Member for West Dorset (Mr. Letwin) went to the heart of several important issues relating to the Bill. The measure is timely and it neatly unites the interests of both consumers and farmers. As several hon. Members have said, there is growing outrage among the public about defects in the current labelling laws. When consumers come to appreciate the true situation, they are shocked. It is wrong that products that do not contain a single ingredient that has been produced in this country may be labelled as British. That is outrageous, and many would regard such practices as a fraud on consumers who are deceived into buying the goods.
As concern over the scandal mounts, many organisations have tried to respond on a voluntary basis. I welcome the steps taken in respect of the British kitemark label and the co-operation between the National Farmers Union, the Meat and Livestock Commission, the Food and Drink Federation and the British Retail Consortium. All those bodies are doing good work and they have our support. The more that can be achieved on a voluntary basis, the better, but it would be better still if we could take the route signposted by my hon. Friend's Bill. Agriculture now faces its worst crisis for two generations. One response to that crisis should be the introduction, with no qualifications, of honesty in labelling—a principle to which the Conservative party is wholly committed.
Individual sectors of agriculture have been mentioned, including pig farming. I was disturbed to learn during the debate that a complaint originating within the House of Commons has been made about the protest that has been in Parliament square for the past month. I cannot believe that that complaint originated from an Opposition Member, and in that I believe that I can speak with some confidence for the Liberal Democrats as well.
I hope that if a complaint has been made by a Labour Member, steps will be taken to withdraw it, and that the Minister will make it clear that until the pig farmers who

are protesting outside have had their concerns reasonably addressed, as the Prime Minister suggested would happen when he spoke to the NFU conference, the Labour party is happy for their entirely peaceful protest to continue.
There is concern about poultry meat, as we heard, and about some of the beef produced in France, which was the subject of two recent reports. Last year the European Commission inspectors exposed illegal feeding practices taking place in France, and in the past few weeks another European Commission report has uncovered serious deficiencies in the way in which France deals with suspected cases of BSE.
Meat produced under those conditions is entering this country, consumers are buying it, and they have no knowledge that it comes from France, despite the serious anxieties to which those European Commission reports give rise.
The problems encountered by British pig farmers producing to higher standards than many competitors abroad, the dangers to consumers of eating poultry that has been produced using growth-promoting substances that are banned throughout the entire EU for health reasons, and the dangers of eating meat that may have come in from France and which may be contaminated—all those problems would be directly addressed by the measures in the Bill.
Not only is the Bill badly needed, it is needed now. The gravity of the crisis is due in part to the enormous increase in import penetration. British farmers are experiencing difficult conditions—much more difficult than they were before 1997. That is partly because of the level of sterling, a factor outside the Minister's control. As a consequence, competition from imports is probably more severe than it has been for a long time. With the huge growth in the international trade in food products, the need for honesty in labelling is greater than ever.
We have heard many times in recent months from the Prime Minister, from the Agriculture Minister and other Ministers of their support for the principle of honesty in labelling. Today they have an opportunity for that support to be put into practice by allowing the Bill a Second Reading.
My hon. Friend the Member for Eddisbury recognised in his opening speech, and my hon. Friend the Member for West Dorset confirmed, that there may be deficiencies in the drafting of individual clauses, but the time to address those is in Standing Committee. I know that my hon. Friend the Member for Eddisbury would welcome the chance to explore in more detail some of the concerns that have been raised during the debate.
If revisions are needed to make the Bill entirely consistent with our EU obligations, my hon. Friend and I are ready to support them, as long as the thrust of the Bill is not destroyed. I hope that in dealing with the EU requirements, Ministers and the House will be robust in their defence of British interests. That is necessary at all times, and it would certainly be needed in relation to the Bill.
If the Government decide to talk the Bill out today or use any other mechanism to block its progress to the next stage by denying it a Second Reading, they will be sending a clear and rather chilling message to consumers and farmers throughout Britain. Every rural community will be listening eagerly to the Minister's remarks and to the outcome of the debate.
If Labour is not willing to offer support during the present crisis by allowing a Second Reading to a Bill that does not add a single penny to public spending and that embodies the principles that Ministers claim to support, Labour will be judged by its actions, not its words. It will rightly be judged harshly and condemned for denying the House a chance to examine in more detail a measure that is entirely constructive in its approach.
If the Bill does not get a Second Reading today, all those fine phrases from the Prime Minister and other Ministers will be exposed as utterly worthless. There is time for the Government to support the Bill, and I urge them to do so.

The Minister of State, Ministry of Agriculture, Fisheries and Food (Ms Joyce Quin): The debate has been interesting and worth while, and many valid points have been made. I congratulate the hon. Member for Eddisbury (Mr. O'Brien) on his good fortune in securing such a good position in the ballot and on raising an important issue.
The right hon. and learned Member for North-East Bedfordshire (Sir N. Lyell) pointed out that I nodded much during the speech of the hon. Member for Eddisbury. I do not apologise for doing that because I agreed with many points that he made. My initial reaction to the Bill was understanding, sympathy and support. However, when I examined the few clauses in the measure, I had severe reservations about it. In the short time available, I hope that I can explain the reasons for that to the House. Hon. Members from all parts of the House have asked questions about the Bill's feasibility.
As my hon. Friend the Member for St. Helens, South (Mr. Bermingham) pointed out, the substance of the Bill is contained in clauses 2 and 3. The problems of compatibility with European law that several hon. Members pointed out unfortunately exist. As I pointed out in an earlier intervention, the previous Government helped to effect that European law. Clauses 2 and 3 contravene EU law and that means that the Bill contravenes it.
Consistency is important. The hon. Member for Eddisbury said that he was worried about any suggestion that the Bill contravened EU law and that it was not his intention, even if it was that of others, to "clobber"—I think that was the word he used—EU law through the Bill. However, clauses 2 and 3 would do exactly that. They would mean acting unilaterally on matters about which we agreed under previous legislation to act in the framework of the European single market. Despite the Euro-scepticism that reigns among Conservative Members, the Conservative party and certainly the Liberal Democrats have a strong commitment to the operation of the European single market, which is important for our industry. It is important for agriculture as well as other industries.
Various sectors of agriculture export to other EU countries and it is important to safeguard those exports and ensure to the best of our ability that the European

market works fairly. I am the first to admit that many aspects of that European market do not work fairly. The Government are seeking to tackle those aspects.

Mr. Bermingham: Does the Minister agree that if we pass a law that is incompatible with treaty obligations, the European Court will strike it down?

Ms Quin: My hon. Friend is right. There is no doubt that the substance of the Bill could result in European legal action being pursued. It is important for us to be consistent and the Government have rightly said that we obey European laws to which we have agreed.
The hon. Member for Eddisbury rightly pointed out why we so strongly deplore the French attitude to our beef exports. The hon. Member for South Suffolk (Mr. Yeo) urged us to be robust, so I should report to the House that I was at an annual international agricultural event in Paris yesterday to promote British meat products with members of the Meat and Livestock Commission and our own agricultural community. We sell lamb and sheepmeat to France in considerable quantities and it is therefore important to convey our support for those products. I also held a press conference that firmly criticised the completely unjust unilateral action taken by the French Government and repeated why British consumers have confidence in the high standards that we have introduced, to which Members on both sides of the House have referred.
Given the clear incompatibility of the substance of the Bill with European legislation, I was surprised that two Liberal Democrats spoke in support of it. I remind the House that we had to pay compensation when we introduced legislation that was struck down in the European Court of Justice—even legislation that appeared to be less at risk of being struck down than the Bill. It might have been useful for the right hon. and learned Member for North-East Bedfordshire—the former Attorney-General—to have listened to that point. The most striking example is provided by the Factortame judgment under which the Merchant Shipping Act 1988, which restricted the registration of fishing vessels and was designed to deny Spanish quota-hoppers access to United Kingdom fish quotas, was struck down in the European Court. Substantial compensation had to be paid.
The hon. Member for South Suffolk said that the Bill would not cost the Government anything. If it were implemented in anything like its current form, it could be extremely costly to the United Kingdom and could damage our reputation considerably. Although I agree that the principle behind what the hon. Member for Eddisbury is trying to achieve is dear to all our hearts—it has been the subject of a number of Government initiatives so far—it is simply impossible for us to give the Bill fair passage, knowing what its implications would be.
The hon. Member for Hazel Grove (Mr. Stunell) hopes that the Government will use the Bill as a lever in our arguments with other European countries. Although I am happy to listen to his advice, it is unnecessary because we are already taking action in that respect. I do not want to take a party political approach because there is a lot of common ground between Members on both sides of the House, but I believe that we have been far more active on labelling issues in the EU framework than the previous Government. Indeed, some complaints about the state of EU legislation have arisen from directives into which they entered.
We are strongly committed to giving the consumer relevant information and there is no difference between us on the information that consumers want on labels. We are helping to create a system whereby consumers get more information now, and in the future we will be able to satisfy some of the hon. Gentleman's understandable aspirations.
The Government were taken to task by the hon. Member for West Dorset (Mr. Letwin). He blamed us for not being proactive enough on the Bill. I was once fortunate enough to get a much lower position in the ballot than the hon. Member for Eddisbury, and I wanted to introduce a public safety information Bill. I immediately approached the Department and sought a meeting with the relevant Ministers. Unfortunately, they did not accept my sensible measure. The hon. Gentleman could have come to us. He received support from the National Farmers Union, so I contacted that organisation to explain where we agree with it on labelling initiatives and the reasons why the Bill is not acceptable.

Mr. Letwin: rose—

Ms Quin: If the hon. Gentleman will allow me to continue, I shall come to the point that he specifically raised.
During the debate, many hon. Members have said that it will be possible to deal with some of these issues in Committee. Obviously, if the Bill proceeded into Committee we would have to tackle them. However, it would be tantamount to an abuse of parliamentary procedure to expect a Bill to go into Committee when its two substantive clauses are, in the Government's view and in the opinion of legal advisers, in contravention of Acts already on the statute book and of EU law. The two substantive clauses are incompatible with European law.
We believe that to achieve the goals that the hon. Member for Eddisbury rightly wants to achieve, it is far better for Ministers to pursue the initiatives that they are already taking, and to spend time building up support in the European Union for our objectives, rather than to spend a huge amount of time in Committee on a Bill, the substantive elements of which are not compatible with European law. I think that there has been widespread understanding of that position during the debate.
The hon. Member for Eddisbury also mentioned the importance of the devolution aspects of his proposal. I assure him and the House that Ministers in my Department have regular meetings with the corresponding Ministers and Secretaries in the devolved legislatures and organisations. We are keen to move together on issues to which single market considerations apply, and when we need to present a common position to the European Union to get the changes that he and the Government want to achieve.
The hon. Gentleman referred to the proposed Bill in the Scottish Parliament, which I understand is at an early stage. As he recognised, that Bill refers to labelling of meat, so it is a much narrower measure than his Bill. I think that he would agree that it makes sense to make our approaches compatible. That is not an argument against devolution, of which I am an enthusiastic supporter, but it is a reason to support the approach taken by my Ministry and the Government, which have worked in harmony with representatives of the devolved Administrations to try to ensure that we present a united front on European and single market issues.
During the debate, many references were understandably made—

It being half-past Two o'clock, the debate stood adjourned.

Debate to be resumed on Friday 9 June.

Remaining Private Members' Bills

ORGANIC FOOD AND FARMING TARGETS BILL

Order for Second Reading read.

Hon. Members: Object.

Second Reading deferred till Friday 10 March.

BUILDING SOCIETIES (TRANSFER RESOLUTIONS) BILL

Order for Second Reading read.

Hon. Members: Object.

Second Reading deferred till Friday 19 May.

Committees

PUBLIC ADMINISTRATION

Ordered,
That Mr. Desmond Browne be discharged from the Select Committee on Public Administration and Mr. John McFall be added to the Committee.

ENVIRONMENTAL AUDIT

That Mr. Bob Blizzard be discharged from the Environmental Audit Committee and Mr. Phil Sawford be added.—[Mr. Sutcliffe.]

Silicone Breast Implants

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Sutcliffe.]

Mr. Tom Brake: I am pleased to have the opportunity to bring the House's attention to an issue that affects more and more women in the United Kingdom as well as abroad, on which I believe the Government have so far failed to take decisive action. I first became aware of the health risks associated with silicone implants when I was approached by a constituent whose case will, I believe, interest the House. It raises concerns about the safety of the operation as well as the product itself, but it is the latter that I shall consider in detail.
Dawn contacted me in September last year, having already suffered from the adverse effects of breast implants for more than a year. In June 1998, she found that the implant in her left breast had ruptured and needed to be replaced. In July, the implants were removed and replaced with others; however, Dawn found that the implants had made one of her breasts larger than the other. Moreover, it appeared that the scar tissue was infected.
A course of antibiotics was prescribed in an attempt to resolve the problem, requiring Dawn to return to hospital every week for 10 weeks. However, her condition deteriorated further: holes developed in her breast, requiring her to return to hospital for a further course of antibiotics. It culminated in her being rushed to hospital, where a doctor found that the implant was beginning to fall out. I apologise for going into such detail, but the detail highlights the concern felt by many about the safety not just of the operation, but—as I shall demonstrate—of the product itself.
Further intervention was required: an implant was removed. Subsequently, the wound had to be left to heal, with no stitches, so that the infection could be cleared. That obviously had a detrimental effect on both the physical and the mental well-being of my constituent, who, after what should have been a straightforward operation, was experiencing pain and—because she could not work for a long period—loss of income. She described herself as having been depressed and even suicidal. Moreover, she developed a peptic ulcer, which I think her doctors would suggest was a result of the stress that she experienced.
A further operation was performed to replace the implant, which left my constituent feeling numb on her left side down to the waist. Apparently, she was told that that was perfectly normal. For a further two months she had to visit the doctor every couple of weeks, and was taking painkillers and other medication.
By April, my constituent's doctor was still concerned about one of the implants, which he thought might have encapsulated. There was concern that her lymph glands were swollen. That evening, she was in such pain that she had to be admitted to hospital. After that series of operations, both implants were removed. The doctor informed her that, during removal, staff had had to remove a benign lump from her breast and—this is key—had found silicone around the lymph glands in her armpit.
My constituent continues to suffer the pain and anguish associated with the operation and with what happened subsequently. She continues to see various specialists to


try to get the matter resolved. It seems that hers is not a lone case. She has been in regular contact by e-mail with concerned women throughout the world who are experiencing similar problems. Apparently, she is receiving up to 50 e-mails a day from different parts of the world. People are passing on information about the impact that Dow implants may have had on their health.
Silicone Support UK, which runs a helpline for women with similar problems, has told me that it has been in contact with no fewer than 2,000 women who are suffering from similar symptoms, so it is by no means a unique case. It appears that many thousands of women are affected in the UK and in other countries. I am sure that each hon. Member will have constituents who have health problems that would appear to be associated with either the operation to put the implants in, or the implants themselves, which I learned today contain no fewer than 37 constituent parts; they contain different chemicals or metals. It is not just inert silicone that is contained in implants, but many other materials which Members would find less acceptable and would say were in no way inert.
The problems associated with silicone implants that have been reported by different women range from partial paralysis to arthritis, severe allergies, chronic fatigue syndrome and memory problems. As hon. Members may know, a moratorium on silicone implants exists—except for clinical trials, in the United States and Canada—and they are banned in Australia, Japan and France, so what are the UK Government doing? I would not want to accuse the Government of doing absolutely nothing. Historically, action was taken when public awareness was perhaps at its height. In 1992, the Department of Health set up an independent expert advisory group to investigate the association between silicone gel breast implants and connective tissue disease. Apparently, it found no evidence of a link and no reason to alter existing policy.
In 1993, public anxiety was such that a breast implant registry was established at Salisbury district hospital. Apparently, the registry was to form the basis for future research projects. In 1994, the Medical Devices Agency of the Department of Health, which has continued to keep the issue under review, published a further analysis of the health risks of silicone implants and reached the same conclusions that had been reached in 1992. It is worth noting that medical health professionals are under no obligation to report incidents to the agency: there is a voluntary arrangement, which is a source of concern.
In 1997, the Government set up an independent review group to review all the evidence of possible health risks. The history is that, as concern has mounted, the Government have naturally wanted to reassure the public and be seen to be doing something, but being seen to do something is about all that it amounts to.
Let us examine a specific example. The breast implant registry at Salisbury district hospital was set up in 1993, nearly eight years ago. A parliamentary question that I tabled recently has identified that, since the registry was established, no research has yet been published.
The purpose of the registry is to collate information on breast implants, to enable research to be undertaken on the basis of that information and identify potential problems. However, although the registry has been up and running for seven years, no research has been published. I have been told that only one research project is under way. If one research project is all that the registry has been able

to achieve in the past seven years—perhaps the Minister will correct me if it has accomplished more than that—it is not a terribly great achievement.
The registry contains details on 40,000 implant recipients, the ages of whom range from 12 to 80. The registry's scientific co-ordinator states:
Current uses of the registry are concerned with improving and extending this process, raising awareness of the process, increasing the proportion of total procedures that are registered, internal audit with collaborating centres and assisting with some vigilance and safety concerns.
Perhaps the Minister will say precisely how the registry has been able to raise "awareness of the process" and how the proportion of total registered procedures has increased since the registry was established in 1993.
The fact that no research has been completed might explain why no findings have been published. Surely the Minister will agree that, so far, it seems to be a case of activity for its own sake, rather than to serve a specific purpose. I wonder how the registry is informing the Government's policy. I should also like to know how much money has been invested in the registry. Perhaps the Minister will clarify that issue—if not now, then later, in writing. The registry does not so far seem to have been terribly good value for money.
The independent review group was established in 1997, to review all the evidence on possible health risks, and it reported in 1998. It identified various problems and made various important recommendations. The key issue is information and advertising. Hon. Members may have seen advertisements in various women's magazines, such as the one I am holding, which mention the "Natural look", "Natural feel" and "Natural push-up" of implants. There is nothing in the advertisements about the possible health and safety implications of implants. As a doctor told me, the results that are demonstrated in photographs in such advertisements are always perfect, whereas, as doctors accept, in many cases, the results can be anything but perfect.
What response has there been to the independent review group's recommendation that better information on implants should be provided? The Advertising Standards Authority and the Government are considering how best to deal with the matter, and they will seek to ensure that information on the risks of implant surgery is made readily available. However, it is another case of action in progress, but nothing delivered. The absence of advice for women on breast implants is a major stumbling block.
The independent review group also recommended that all patients undergoing surgery should be able to obtain free of charge comprehensive information from a designated body. I was told in the answer to my parliamentary question that such information would be available by the end of 1999, but that information has still not materialised. Will the Minister clarify when that freely and readily available information on the operation—to inform women of the risks, and perhaps of the financial costs—will be available to the general public? I have been told that information from the European Union on implants could be made available, but has been refused as inappropriate or not good enough for the United Kingdom. If that is not good enough, could we have something very quickly that is?
The Government banned soya bean breast implants one year ago, after reports of 74 adverse incidents among the 5,000 women who had received such implants since they were introduced in 1995. Apparently, they were banned in accordance with the precautionary principle. Perhaps the Government were concerned about genetically modified organisms in soya when they banned those implants on the basis of the precautionary principle, which is now being advanced as a reason for scaling down the use of genetically modified organisms.
The deputy chief medical officer commented last year:
The Medical Devices Agency has received reports of local complications in a small number of women who have trilucent implants. There has been no evidence of permanent injury or harm to health…However on the precautionary principle we consider that no more of these devices should be implanted.
If those particular implants have been banned on the basis of the precautionary principle, there is at the very least a persuasive argument for the Government to ban silicone implants, as has been done in many other countries. I know that the Minister will not concede that today, but I hope that she will give me the modest assurance that the Government will agree to look at the matter again, perhaps with a greater degree of urgency than has been demonstrated so far. For my constituent, Dawn, and thousands of women like her, that is the very least that we can demand.

The Parliamentary Under-Secretary of State for Health (Ms Gisela Stuart): I thank the hon. Member for Carshalton and Wallington (Mr. Brake) for raising this issue, which is of great concern to many women who have, or are thinking of having, breast implants. I should also like to take the opportunity to express my sympathy for his constituent. No one underestimates or doubts the considerable distress that she has suffered.
Currently, there is much confusion about silicone breast implants and we are determined to get straight, evidence-based information, validated by Department of Health experts, to women and general practitioners, so that they can take appropriate decisions about their own health care—including women who have had implants and those who are thinking of having them.
The hon. Gentleman will know that a systematic review of the evidence is the way to get a rational debate on the issue. I am grateful for the opportunity to reassure him that the Department of Health does not just wish to be seen to be doing something about it, but is doing something and to share that information with the hon. Gentleman and the House.
Regulations are in place throughout Europe and they include essential requirements for safety and performance which apply to all medical devices, including breast implants. It is important to acknowledge that there are risks inherent is all medical procedures, but the regulations require that any risks associated with medical devices are considered acceptable when balanced against the benefits arising from the use of a device.
The Department of Health's Medical Devices Agency identified the breast implant device to which the hon. Gentleman referred—the one filled with soya bean oil rather than silicone gel—as possibly unsafe and it was

withdrawn from clinical use last year. In the same way, the MDA identified potential safety concerns several years ago in relation to polyurethane-coated breast implants and took steps to ensure that these implants were no longer used. When we first became aware of concerns in these cases, and in the case of silicone breast implants, we started by reviewing the available data and took action.
In the case of silicone gel breast implants, the data reviewed provided consistent reassurance that risks to patients were no greater than for other implants.
The possibility that silicone gel breast implants might cause connective tissue disease was first suggested in 1991. I shall not repeat the review process that the hon. Gentleman accurately identified. He also drew attention to the setting up in 1993 of the National Breast Implant Registry at Odstock hospital in Salisbury.
In spite of the reassurances, many women remained convinced that their breast implants may have been the cause of the debilitating illnesses they were suffering. Precisely because of those continuing concerns, one of the first actions the Government took when they came to power in May 1997 was to ask the chief medical officer to take a fresh look into the issues surrounding silicone gel breast implants.
The CMO set up an independent review group with the task of reviewing the possible health effects associated with silicone gel breast implants and the issues relating to pre-operative patient information examining.
The IRG is chaired by Professor Roger Sturrock, an internationally acknowledged expert in rheumatology. The findings of the IRG were published in July 1998, and I shall outline some of the actions that were taken as a result of those recommendations. I shall briefly summarise its conclusions. First, silicone gel breast implants were not seen to be associated with any greater health risk than other surgical implants. Secondly, the IRG found no evidence for an abnormal immune response to silicones or for any link between silicone gel breast implants and any established connective tissue disease.
Those conclusions are corroborated by the earlier assessments by the Department of Health, the American Medical Association, the Canadian Independent Advisory Committee, the National Science Panel appointed by the US federal court, and the Institute of Medicine of the US National Academy of Science. Importantly, the IRG also pointed out that the information provided to women undergoing breast implantation was of poor quality, and that that needed to be addressed.
The hon. Gentleman mentioned the recommendations made by the IRG and I shall take them step by step. In relation to information for patients and the consent required, the IRG recommended that information should be provided to patients about benefits and risks and the likely financial implications. It also recommended that a specific consent form should be developed, incorporating all the relevant issues. In response, we set up a small group led by Baroness Emerton of Tunbridge Wells to produce independent advice for women considering breast implants. A team comprising health care professionals, women who have had breast implants and representatives of other interested organisations—including the independent sector—has produced an information booklet. The booklet was issued widely for consultation—because it is important that we get it right—between July and September last year, and 100,000 copies will be


published at the end of the month. The booklet will be available through the NHS health literature line on 0800 555 777, the Health Information Service, NHS Direct and on the Department of Health website.
The IRG also expressed concerns about the control of advertisements. The Department of Health has discussed those concerns with the Advertising Standards Authority, and we are working with the ASA on the standards that we think advertisers should observe, with a view to involving the ASA in action against those producing materials for the public that could be misleading and dangerous to health.
The hon. Gentleman also mentioned adverse incidents and the Medical Devices Agency published guidance on the reporting of breast implant-related adverse incidents in 1999. That was circulated to plastic surgeons, to hospitals and clinics in both the public and private sectors and to manufacturers. It includes advice to manufacturers on which incidents they have, by law, to notify to the MDA. The guidance is also useful to plastic surgeons and other health service staff, who can report adverse incidents directly to the MDA's adverse incident centre. Over the past two years, we have spent some £50,000 investigating adverse incidents with breast implants.
In relation to standards of care, a Royal College of Surgeons committee, under the chairmanship of a leading plastic surgeon, Mr. Michael Brough, is now developing clinical guidelines for breast implant surgery. Those will also address the issue of consent.
The hon. Gentleman will also be aware that the Care Standards Bill, currently awaiting Report stage in the other place, will introduce a new framework and recommendations for control of the independent health care sector that will benefit women who use that sector by imposing clinical standards, complaints procedures and monitoring.
The IRG also recommended that registration of implants with the National Breast Implant Registry should be compulsory. In the UK, reporting by clinicians is an aspect of good professional practice rather than a legal requirement. The entry of data onto a registry also requires consent by the patient. Therefore, registration cannot be made compulsory.
The intent behind the IRG's recommendation can, however, be met by increasing compliance. Since 1994, more than 40,000 implants have been registered. It is important to note that the number registered in 1998 was almost four times the number registered when the register was established.
The cost of the national breast implant registry to date is £200,000. This year, the MDA has increased this level of funding by £20,000, to allow an increase in compliance monitoring.
The hon. Member for Carshalton and Wallington asked what had been done with that register. It is intended to be used as a research tool. There is no consistent picture from international research to date on local complications associated with breast implantation, such as rupture and contracture. That is why the Department of Health is planning a study to look at this, based upon patients registered in the first years of the breast implant registry. It is only now that we can use registry data as a basis for such research, as reliable answers on the incidence of local complications cannot be obtained until at least five years of data have been acquired.
We must wait even longer for any registry-based research into systemic diseases, such as connective tissue disease, since those diseases would not manifest themselves until about 10 years after implantation. However, between 2 million and 3 million women around the world are estimated to have received breast implants, and the IRG agreed that the question of the incidence of systemic disease has already been addressed by studies from North America and Europe.
Finally, the IRG recommended that a steering group be set up to organise research, and that new information should be kept under review. In March 1999, the Department of Health's research and development division established a steering group to monitor current research and to consider areas and approaches for new research of high scientific quality. The group includes a consultant plastic surgeon, an emeritus professor of immunology, a representative from industry and Professor Kent Woods, the chairman of the NHS health technology assessment programme.
In January, it considered the results of research on antibody tests carried out on Dutch women with silicone gel breast implants. The Dutch work is thorough, but so far it has failed to show any association between antibody test results and the degree of disability in the women examined. However, the IRG continues to meet about twice a year to review any new evidence related to its remit, and we are committed to continuing to respond to its recommendations.

Mr. Brake: I thank the Minister for giving way and, given the time, she may have to respond in writing to the questions that I want to ask. First, will she clarify whether the voluntary arrangement about reporting incidents requires patients' consent? Will personal details be stripped out of the information, so that an accurate picture can be built up about the problems associated with certain products?
Secondly, when will the Department complete the study using the register, and what will be its terms of reference?

Ms Stuart: I can tell the hon. Gentleman that the Royal College of Surgeons is reviewing the data consent form to ensure increased compliance. The terms of reference for the research based on that data have been framed to accommodate the fact that immunological data must be acquired over a period of 10 years.
I turn now to information available on the Department's website. The internet is a powerful tool, but it carries much unreliable information. The Department's website ensures that women have access to reliable information.
Finally, I can assure the hon. Gentleman that the Government's financial commitment to this matter is not inconsiderable. Since April 1997, we have spent in excess of £800,000 on the monitoring programme. That covers £450,000 for MDA staff time, £250,000 for the IRG, and £100,000 for the national breast implant registry.
The Government are determined that women should have access to reliable information, and to continue to research and monitor an issue that causes a lot of concern to women. Some of that concern may be unnecessary.

Question put and agreed to.

Adjourned accordingly at one minute past Three o'clock.